RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01520
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20040607

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Petroleum Supply Specialist, medically separated for “plantar fasciitis” with a disability rating of 0%.   

CI CONTENTION:  “PTSD (rank reduction) caused by stress after Operation Iraqi Enduring Freedom.  Patellar Tendonitis (knee injury) Pes Planus, Planta Fascitis [SIC].”  The CI also submitted a lengthy letter to accompany his application.  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 it reasonably reflects the severity of the disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20040422	VARD - 20060111	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Plantar Fasciitis	5399-5310	0%	Chronic Bilateral Plantar Fasciitis and Pes Planus	5284-5276	0%	STR	
Patellar Tendinitis	Not Unfitting	No VA Rating in Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Plantar Fasciitis (PF).  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), he was evaluated by podiatry 20 February 2004 when evaluated in podiatry and found to have severe pes planus valgus.  During the 8 March 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported that his foot pain was aggravated with wearing of boots, prolonged standing, and carrying heavy loads.  On examination, the CI was noted to have symptomatic moderate pes planus.  The plantar arches were mildly tender.  The examination of the feet was otherwise negative.  X-rays on 8 March 2004 showed subtle bilateral degenerative changes at the base of the great toes.  Otherwise, the X-rays were normal and pes planus was not seen.  At a follow-up podiatry examination on 15 March 2004, range of motion was full and strength was normal.  A sign of flat feet, “too many toes,” was present.  The CI was able to hop on one leg albeit with pain.  

The 31 March 2004 MEB NARSUM, 2 months prior to separation, noted that no records were found for the CI’s foot pain.  [The panel observed that on a post-deployment questionnaire dated 9 May 2003, the CI reported left knee pain and denied that he had been seen in sick call.]  The examiner who prepared the NARSUM also completed the DD Form 2808, noted above, and referenced that examination.  There was no VA examination proximate to separation in evidence. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the PF condition 0%, coded analogously as 5310 (Group X, muscle injury), citing slight Group X muscle injury.  The VA also rated the PF condition 0%, dual coded as 5284-5276, (other foot injury and acquired flatfoot), based on the STR, citing mild symptoms relieved by built-up shoe or arch support.  The CI did have pain on manipulation of his feet.  It is not clear if there was a change in the weight bearing line or bowing of the Achilles tendon, but the podiatry note was only partially legible.  A 10% rating for the bilateral foot condition was supported under code 5276.  There was no evidence of an injury to support a compensable rating under 5284.  A 10% rating for moderate impairment under code 5310 was considered, but this level of impairment was not recorded.  Although painful, the CI could hop on one foot.  The panel observed that the CI was found unfit for plantar fasciitis without specification if unilateral or bilateral.  This was also true of the MEB and profile.  The examination and NARSUM did address both feet.  The evidence supported a finding that each foot was separately unfitting.  Under the code 5276 though, this provided no advantage to the CI.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the PF condition, coded 5276.  

Contended PEB Condition:  Patellar Tendinitis.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was not profiled at separation although it was implicated in the commander’s statement.  It was judged to meet retention standards.  It was noted in the record that an MRI had been negative.  The physical examination was unremarkable other than tenderness of the left knee.  After due deliberation, the panel concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the PF condition, the panel unanimously recommends a disability rating of 10%, coded 5276 IAW VASRD §4.71a.  In the matter of the contended patellar tendinitis condition, the panel unanimously recommends no change from the PEB determination as not unfitting.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Bilateral Plantar Fasciitis with Pes Planus	5276	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161021, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180001642, XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs and to the counsel you listed on your application; [name and address].

Sincerely,					      
						      					
Enclosure