RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01708
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20040914

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Multiple Launch Rocket System Operations Field Specialist, medically separated for “bilateral plantar fasciitis” with a disability rating of 0%.  

CI CONTENTION:  The conditions have worsened since separation.  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 - 20040528	VARD - 20050503	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Plantar Fasciitis	5399-5310	0%	Plantar Fasciitis, Right Foot	5099-5020	10%	STR	
			Plantar Fasciitis, Left Foot	5099-5020	10%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Bilateral Plantar Fasciitis (PF).  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral leg pain condition began in March 2003 with no specific trauma.  He was initially thought to have bilateral shin splints on clinical examination.  On 2 May 2003 the CI was noted to have a normal gait.  A bone scan was unremarkable other than a possible stress injury of a bone in the right mid foot.  On 8 August 2003 he was diagnosed with bilateral plantar fasciitis and treated with medications and stretching.  His pain persisted and he was issued arch supports.  On 6 February 2004 he reported increased pain in both feet despite medications and the use of the arch supports.  His feet were very tender to gentle palpation and the range of motion (ROM) was “significantly curtailed” by pain.  Three weeks later, tenderness remained, but the ankle ROM, strength, and sensation were normal.  The CI was then entered into the MEB process.  

During the 7 May 2004 MEB NARSUM examination, 4 months prior to separation, the CI reported bilateral pain over the balls of his feet.  This was confirmed on physical examination.  The arches were normal, heels non-tender, and calluses absent.  Ankle ROM was normal.  No comment was made regarding gait or painful motion.  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 bilateral PF condition 0%, coded analogously as 5310 (Group X. Function), citing the condition as mild.  The VA rated the bilateral PF condition 10% for each foot, each coded analogously as 5020, (synovitis), based on the STR, citing each foot was symptomatic.  The panel considered the evidence.  The PEB found both feet to be unfitting and therefore, separately ratable if supported by the evidence.  There is no specific code for PF.  The code 5310 supports a 10% rating for moderate disability.  While the CI was noted to have bilateral tenderness, the gait was recorded as normal albeit over a year prior to separation.  The absence of comment on the gait after this suggests that the gait remained normal or near normal.  This is closer to a slight than moderate impairment.  Code 5020 is rated on limitation of motion which was not present.  However, code 5279 (metatarsalgia) supports a 10% rating for unilateral or bilateral disease.  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 bilateral PF condition, coded 5279.  

BOARD FINDINGS:  In the matter of the bilateral PF condition, the panel unanimously recommends a disability rating of 10%, coded 5279 IAW VASRD §4.71a.  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 the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Bilateral Plantar Fasciitis	5279	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160929, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180002719, 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.

Sincerely,					      
Enclosure