RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00787
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20050329

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Power Generation Equipment Repairer, medically separated for “chronic bilateral foot pain secondary to plantar fasciitis” with a disability rating of 0%.  

CI CONTENTION:  “The severity of plantar fasciitis in both of my feet has changed my life permanently.  I am limited on what I can do for work/recreation and not a day goes by where I am not in pain.  I was discharged because I was told this will not go away and will only get 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 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 - 20050216	VARD - 20060602	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Bilateral Foot Pain Secondary to Plantar Fasciitis	5399-5310	0%	Bilateral Plantar Fasciitis	5299-5276	10%	20050824	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Chronic Bilateral Foot Pain Secondary to Plantar Fasciitis.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s plantar fasciitis began in July 2002 after experiencing pain in both feet while running and ruck marching in basic training.  Over the next few years, he was treated with medications, duty limitations, shoe inserts (orthotics) and night splints.  X-rays were normal and the CI was diagnosed with bilateral plantar fasciitis.  On 30 August 2004, he was noted to have a normal gait.
At the 14 December 2004 MEB podiatry consultation, 4 months prior to separation, the physical examination showed a mild decrease in the arch, but he had normal range of motion and sensation.  During the 19 January 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported ongoing bilateral foot pain with some benefit from orthotics.  On examination, he was noted to have tender, flat feet.  The 8 February 2005 MEB NARSUM examination, 1 month prior to separation, noted complaints of ongoing bilateral foot pain despite treatment.  

At the 28 June 2005 primary care examination, 3 months after separation, a normal gait was noted.  The 24 August 2005 VA Compensation and Pension (C&P) evaluation, 5 months after separation, noted the CI was not using orthotics for his bilateral foot pain.  The examiner noted the CI wore sandals for the examination and that these provided “very modest” arch support.  The CI stated that he had problems with prolonged walking and standing.  The physical examination showed bilateral pronation (turning outward) of the feet, but did not show flat feet (pes planus).  Some tenderness of the insertion of the plantar fascia was noted, right greater than left.  The ROM was full and signs of abnormal weight bearing or calluses were absent.  The examination was otherwise unremarkable.  At the 16 November 2005 primary care examination, 7 months after separation, a normal gait was again noted.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the plantar fasciitis 0%, coded 5399-5310 (analogous to Group X muscle injury).  The VA rated the plantar fasciitis 10%, coded 5299-5276 (analogous to acquired flatfoot), based on the C&P examination, citing weight-bearing line over or medial to the great toe with inward bowing of the tendo Achillis and pain on manipulation and use of the feet.  The panel considered the evidence.  The gait, when recorded, was normal.  Some tenderness was recorded of the plantar fascia, but the examination of the feet was otherwise relatively unremarkable.  The evidence did not support an impairment higher than slight as adjudicated by the PEB at 0% rating.  While each foot could be considered separately unfitting, this provided no rating advantage to the CI.  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 plantar fasciitis.  

BOARD FINDINGS:  In the matter of the plantar fasciitis and IAW VASRD §4.73, 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. 

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170215, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180004907, 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