RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2016-00950
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20040531

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Logistics Vehicle Systems Operator, medically separated for “chronic Achilles tendinitis, right foot” with a disability rating of 10%.  

CI CONTENTION:  He had issues with both feet but did not get a rating for his left foot.  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 - 20040318	VARD - 20050629	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Achilles Tendinitis, 
Right Foot	5099-5003	10%	Achilles Tendinitis, Right Foot with S/P Excision Haglund’s Deformity	5299-5284	20%	20040403	
Status Post (S/P) Excision Haglund’s Deformity, Right Foot	Cat II					
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:  

Chronic Right Foot Achilles Tendinitis.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI had bone enlargement at the back of both heels for many years, and underwent a resection of a right Haglund’s deformity (retrocalcaneal exostosis) in November 2002.  

The 10 September 2003 MEB NARSUM examination, 9 months prior to separation, noted ci complaints of pain while on his feet wearing military boots for over 20 minutes.  Physical examination revealed a notable 3-cm area of soft tissue swelling on the back of the right Achilles tendon insertion at the heel.  There was tenderness to the surgical area (but not the actual scar) and pain with active dorsiflexion and plantar flexion of the Achilles tendon.  There was also a posterior calcaneus prominence at the margin of the resection.  

At the 3 April 2004 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported right foot pain rated at 7/10 after standing 10-15 minutes.  Physical examination showed a normal gait, and no swelling, effusion, muscle spasm, joint laxity, muscle atrophy, or evidence of fracture.  The Achilles tendon appeared normal, but there was a 1.5 cm protrusion over the posterior aspect of the calcaneus at the insertion; there was no ankle joint involvement.  The CI’s posture when standing and squatting, with supination and pronation of the toes and heels, were all within normal limits.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right Achilles tendinitis 10%, analogously coded 5099-5003 (degenerative arthritis), citing the condition existed prior to service, but reduced the rating by 0%.  The VA rated the right Achilles tendinitis  20%, analogously coded 5299-5284 (foot injuries, other), based on the C&P examination, citing significant pain to include marked fatigability with repetitive activity.  Members agreed the right foot condition was no more than moderate, therefore supporting a 10% rating coded 5284 (foot injuries, other).  There was no acquired flatfoot (5276), weak foot (5277), claw foot (5278), to support rating under those respective codes; and no unilateral or bilateral metatarsalgia (5279) or tarsal or metatarsal bone malunion or non-union (5283).  Additionally, there was no ankle limitation or ankylosis (5271, 5270).  The panel considered alternative VASRD ankle and analogous codes, but all were less applicable and not advantageous to rating.  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 right foot injury condition.  

BOARD FINDINGS:  In the matter of the chronic right foot Achilles tendinitis and IAW VASRD §4.71a, 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.  

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: