RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01428
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20040719

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E5, Microwave Systems Operator, medically separated for “chronic right foot pain” with a disability rating of 10%.   

CI CONTENTION:  “My foot is getting worse.”  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 - 20040610	VARD - 20050315	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Foot Pain	5009-5003	10%	Chronic Right Foot Pain	5284	10%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY: 

Chronic Right Foot Pain.  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right foot pain condition began in January 2003 after playing basketball while on active duty.  X-rays on 10 March 2003 revealed “no evidence of fracture, dislocation, arthritic or inflammatory change.”  The radiologist opined that the CI’s right foot was a “normal foot.”  On 14 April 2004, a bone scan of the ankles and feet revealed a “reactive bone formation in the right tibial sesamoid bone” which suggested a fracture of the sesamoid.

A 5 May 2004 podiatric evaluation noted range of motion (ROM) of the right metatarsal phalangeal (MTP) joint was limited to 52 degrees of dorsiflexion compared to normal motion on the left, and 30 degrees of plantar flexion bilaterally. There was no pain noted with joint movement. 

During the 10 May 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the CI reported a broken bone in his right foot.  Physical examination showed the plantar aspect of the right first MTP joint was tender to palpation.  The examiner noted “chronic right foot pain” and that “surgery was not deemed helpful.”  There was no VA examination in evidence proximate to separation. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic right foot pain condition 10%, coded 5009-5003 (arthritis, degenerative) citing “markedly limits mobility” and “some loss of dorsiflexion.”   The VA rated the chronic right foot pain condition 10%, coded 5284 (foot injuries, other) based on the STR and citing mild degenerative changes at the MTP joint on the big toe found on X-rays.  Members agreed the evidence did not support a 20% rating for “moderately severe foot injury or occasional incapacitating exacerbations.”  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 adjudication for the chronic right foot condition.  

BOARD FINDINGS:  In the matter of the chronic right foot condition and IAW VASRD §4.71a, the panel unanimously 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 20161011, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20180001950, 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