RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01065
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:   20040827

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Trainee, medically separated for “right metatarsal stress fracture ” with a disability rating of 10%.   

CI CONTENTION:  The CI made no contention.  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 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 - 20040723	VARD - 20050608	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Metatarsal Stress Fracture	5279	10%	Residuals, Stress Fracture, Right Foot	5284	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Right Metatarsal Stress Fracture.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right metatarsal stress fracture condition began in March 2004 at the end of basic training.  There was no specific injury or trauma.  Bone scan showed increased uptake in the right first cuneiform region consistent with a stress fracture.  During the 25 June 2004 MEB examination (recorded on DD Forms 2807 and 2808) 2 months prior to separation, the CI reported a stress fracture of the right metatarsal bone.  Physical examination showed interphalangeal pain in the medial midfoot.  
  
The 25 June 2004 MEB NARSUM examination, 2 months prior to separation, noted complaints of constant pain, requiring nonsteroidal anti-inflammatory drugs but not causing sleep disturbance.  She was unable to run, do push-ups or carry a rucksack.  The CI’s right foot symptoms prevented her from running without being in undue pain.  Physical examination showed tenderness of the medial midfoot with full range of motion and intact neurovascular function.  By AMA rating guidelines, pain was slight and constant.  There was no VA Compensation and Pension (C&P) examination in evidence proximate to separation in evidence. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right metatarsal stress fracture condition 10%, coded 5279 (metatarsalgia, anterior (Morton’s disease), unilateral, or bilateral).  The VA rated the residuals, right stress fracture, right foot condition 0%, coded 5284 (foot injuries, other), based on service treatment records.  Panel members agreed there was no pathway to a higher rating under the 5279 code.  There was no evidence of moderate foot injuries under the 5284 code, given the AMA rating as slight and constant.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the right metatarsal stress fracture condition.  

BOARD FINDINGS:  In the matter of the right metatarsal stress fracture condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be 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

AR20170015829, 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