RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01152
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20040215

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Supply Administrations and Operations Clerk, medically separated for “[right and left foot] neuropathy,” rated 10% each, with a combined disability rating of 20%.

CI CONTENTION:  “Nerve damage.”  The complete submission is at Exhibit A.

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the Medical Evaluation Board (MEB), but determined by the PEB to be not unfitting or non-compensable.  Any conditions outside the panel’s defined scope of review, and any contention not requested in this application, may remain eligible for future consideration by the Board for Correction of Military Records.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for the unfitting medical condition(s) at the time of separation.  The panel has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions; that role and authority is granted by Congress to the Department of Veterans Affairs, which operates under a different set of laws.  The panel gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of disability at the time of separation.

RATING COMPARISON:

SERVICE PEB - 20031203	VARD - 20040310	
Condition	Code	Rating	Condition	Code	Rating	Exam	
[Right Foot] Neuropathy	7122	10%	Right Foot Neuropathy	7122	10%	20031219	
[Left Foot] Neuropathy	7122	10%	Left Foot Neuropathy	7122	10%		
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Neuropathy.  The frost bite injury occurred to both feet at the same time.  Both feet were clinically examined at the same time and are presented in one narrative below.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s bilateral foot neuropathy began in January 2003 after experiencing frostbite during military training. He was treated with medications and physical therapy.  He had sensory changes on physical examination which were confirmed during electrodiagnostic testing.  He reported improvement with treatment, but it was insufficient for full duty and he was referred for MEB.  

The 5 September 2003 MEB NARSUM examination, 5 months prior to separation, noted complaints of bilateral burning and tingling at the tips of the toes which was aggravated by walking greater than 15 minutes.  Physical examination showed a decrease in bilateral foot sensation to light touch and vibration.  

At the 19 December 2003 VA Compensation and Pension (C&P) general examination, 2 months before separation, the CI reported ongoing bilateral foot pain aggravated by activity and worse at the end of the day.  Physical examination showed a normal gait to include heel-to-toe walking.  He was able to perform repetitive squatting and alternate leg hopping without difficulty.  The skin examination was normal.  Laboratory testing and X-rays were unremarkable.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated both foot conditions 10% each, coded 7122 (cold injury residual).  The VA also rated both foot conditions 10%, also coded 7122, based on the C&P general examination, citing some diminution to light touch and sharp dull discrimination over the toes.  The panel noted there was slight impairment of sensation over the toes of each foot; however, there was no documented cold sensitivity plus tissue loss, nail abnormality, color changes, or hyperhidrosis (excessive sweating) and foot X-rays were unremarkable to support a 20% rating for either foot.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the bilateral foot neuropathy.

BOARD FINDINGS:  In the matter of the bilateral foot neuropathy and IAW VASRD §4.104, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161003, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref: (a) DoDI 6040.44

      In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC