RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2016-00963
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20040930

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Multiple Launch Rocket System Crewmember, medically separated for “right mid-foot degenerative joint disease (DJD)” with a disability rating of 20%.  

CI CONTENTION:  He requests a higher rating for his foot.  He also requested several other conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) be reviewed.  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 PEB to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined 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.  Furthermore, the panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to 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, operating 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 the disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20040810	VARD - 20050217	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Mid-Foot DJD	5284	20%	Residuals, Status Post Fracture 3rd Metatarsal, Right Foot	5283	20%	20050107	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Mid-Foot DJD.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent surgical fixation on 5 December 2002.  A second surgery was performed on 2 July 2003 due to failure of previously placed surgical hardware.  The 1 July 2004 MEB NARSUM examination, 3 months prior to separation, noted complaints of right foot pain.  Physical examination (PE) revealed tenderness atop the right foot and painful motion upon foot manipulation.  Ankle range of motion (ROM) was full.  The provider additionally noted, “He [the CI] is able to perform all of the activities of daily living.”   
At the 7 January 2005 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the CI reported continued right foot pain.  Physical examination revealed tenderness and decreased ROM of the right ankle.  Dorsiflexion measured 15 degrees (normal 20) and plantar flexion measured 35 degree (normal 45).  Painful motion was not addressed. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right foot condition at 20%, coded 5284 (foot injuries, other).  The VA also rated the right foot condition at 20%, coded 5283, (tarsal, or metatarsal bones, malunion or nonunion), based on the C&P examination 3 months after separation, citing “malunion or nonunion of the tarsal or metatarsal bones with moderately severe symptoms.”

Panel members first agreed that either VARSD codes as used by the PEB and VA were appropriate given the characteristics of the condition and its clinical findings.  Therefore, having the same criteria for each of these codes, the question remained as to whether or not the intensity of impairment met the highest 30% (severe) level.  Members concluded that the CI’s ability to perform all activities of daily living (as addressed 3 months prior to separation) would not support a “severe” level of impairment.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB’s adjudication of the right foot condition.  

BOARD FINDINGS:  In the matter of the right foot condition 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. 

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160919, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180003367, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,					      
						      					
Enclosure