RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX	CASE:  PD-2017-00476
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081202

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Air Traffic Control Operator, medically separated for “chronic bilateral foot pain” with a disability rating of 20%. 

CI CONTENTION:  Review all conditions.  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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB – 20080925	VARD - 20090428	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Bilateral Foot Pain Due to Plantar Fasciitis	5299-5284	10%	Left Foot Plantar Fasciitis	5099-5020	10%	20081112	
		10%	Right Foot Plantar Fasciitis	5099-5020	10%	20081112	
Obesity	Not Unfitting	No VA placement	
Nicotine Dependence	Not Unfitting	No VA placement	
Sensorineural Hearing Loss	Not Unfitting 	Hearing Loss	6100	NSC	20081114	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Chronic Bilateral Foot Pain due to Plantar Fasciitis.  According to the service treatment record and MEB narrative summary (NARSUM), the CI had a long history of non-traumatic bilateral foot pain and treatment.  Foot X-rays, and CT and bone scans were negative, and medications, orthotics and other conservative treatment options were ineffective.  He underwent right foot surgery with plantar fasciotomy on 3 July 2008, and by 26 August 2008 he reported constant pain especially with running and carrying heavy objects.  However, he was working as an air traffic controller and able to climb up the tower.  After maintaining a pain log, the CI noted that none of the treatments had helped.

During the 11 September 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported chronic bilateral foot pain.  Physical examination revealed pain with extreme dorsiflexion of the feet, and tenderness, right greater than left, over the plantar surface of the feet from the ball to the heel.  

At the 12 November 2008 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported bilateral foot pain with soreness, aching, tenderness and fatigability, especially with prolong standing and walking.  He still wore orthotics, but they did not significantly improve symptoms.  Physical examination showed a right foot scar with pain and tenderness over the plantar surface of both feet.  There were no other deformities or abnormal weight bearing, and he was able to heel and toe walk.  Right foot X-rays showed no significant bone or joint abnormality.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left and right foot conditions 10% each, analogously coded 5299-5284 (foot injuries, other), citing “moderate injury to both feet.”  The VA also rated the left and right foot conditions 10% each, but analogously coded 5099-5020 (synovitis), based on the C&P examination, citing painful or limited motion of a major joint or group of minor joints.  Panel members noted that code 5399-5310 (Group X) is usually used for plantar fasciitis, with a 10% rating for a “moderate” disability and a 20% for “moderately severe.”  Although the CI reported more pain in the right foot than the left foot, it was just 5 months post-surgery when he was separated and healing was still in progress.  Additionally he was able to walk up the tower to perform his duties as an air traffic controller.  Thus, the panel agreed that neither foot approached the moderately severe level of disability under code 5399-5310, code 5299-5284, or any other foot code.  After due deliberation, considering all 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 bilateral foot pain.  

Contended PEB Condition: Sensorineural Hearing Loss.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  Although the contended condition was profiled, it was not implicated in the commander’s statement and did not fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.  

Contended PEB Conditions:  Obesity and Nicotine Dependence.  IAW DoDI 1332.38, enclosure 5, obesity and nicotine dependence are conditions not constituting physical disabilities.  Therefore the panel has no basis for recommending either of them for additional disability rating.

BOARD FINDINGS:  In the matter of the bilateral foot pain and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended hearing loss, the panel recommends no change from the PEB determination as not unfitting.  In the matter of the contended obesity and nicotine dependence, the panel agrees it cannot recommend it for additional disability rating.  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 20170214, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190011714,  

Dear XXXXXXXXXXXXX:

	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.