RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00702
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090101

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Food Service Specialist, medically separated for “chronic painful right first MTP (metatarsophalangeal) joint” with a disability rating of 10%.  

CI CONTENTION:  No specific contention was made.  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 - 20080915	VARD - 20091116	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Painful Right First MTP Joint	5280	10%	Arthritis, Right Great Toe	5280	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Painful Right First MTP Joint.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent right foot surgery for bunionectomy (first MTP) with screw fixation in March 2005.  During the 11 March 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 10 months prior to separation, the CI reported chronic pain in right first MTP joint and use of shoe inserts.  Physical examination showed a tender scar over the dorsal right first metatarsal head with painful movement of the first MTP joint and painful heel raise.  

The 14 July 2008 MEB NARSUM examination, 6 months prior to separation, noted complaints of chronic 6/10 pain in the right first MTP joint.  Physical examination showed a healed 4.5 cm surgical scar over the dorsal distal first metatarsal.  The first MTP joint was tender and there was painful range of motion without swelling.  There was also first MTP joint pain with heel raise.  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 right big toe condition 10%, coded 5280 (hallux valgus, unilateral), citing tenderness along the dorsal and plantar aspects of the first MTP joint and painful motion.  The VA rated the right great toe condition 0%, coded 5280, based on the STR, citing no objective medical evidence pertinent to the CI’s claim.  The CI underwent right hallux valgus surgery (bunionectomy) with evidence of painful motion, but the highest VASRD rating available for hallux valgus (code 5280) is 10%, as adjudicated by the PEB.  Panel members considered alternative VASRD foot and toe analogous codes, but all were less applicable and not advantageous to rating.  There was therefore no higher rating than 10% available under any applicable VASRD 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 toe condition.  

BOARD FINDINGS:  In the matter of the right great toe condition and IAW VASRD §4.71a, the panel 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.  

AR20190007499, 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.