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DEPARTMENT  OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD DC 20374-5023

IN REPLY REFER TO

1850
CORB:003
12 Feb 20

Director, Secretary of the Navy Council of Review Boards 
PD-2017-00955

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 6 Feb 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy of 15 October 2019 for appropriate  action.

2.	On 31 January 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-00955
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20080929

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Rifleman, medically separated for “closed fracture of the third metatarsal bone, left foot and right foot” rated 10% each, for a combined disability rating of 20%.

CI CONTENTION: “I believe my rating should be changed to reflect my willingness to remain on active duty...”  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 - 20080723	VARD - 2009203	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Closed Fracture of the Third Metatarsal Bone	5003-5279	10%	Residual, Fracture, Mid Shaft of Right Third Metatarsal	5283	10%	20081025	
Left Closed Fracture of the Third Metatarsal Bone	5003-5279	10%	Residual, Fracture, Mid Shaft of Left Third Metatarsal	5283	10%	20081025	
Bilateral Metatarsalgia	Cat II	No VA Placement	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 20%	
	
ANALYSIS SUMMARY:

Bilateral Closed Fracture of the Third Metatarsal Bone. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s bilateral foot condition began in January 2008 during a 20K ruck march during infantry training.  The 12 June 2008 MEB NARSUM examination,

3 months prior to separation, noted complaints of bilateral foot pain. Physical examination showed a palpable bone callus over the midshaft of the third metatarsal, bilaterally. Subtalar joint range of motion (ROM) was unrestricted and ankle joint ROM was normal. Painful motion was not addressed.

At the 25 October 2008 VA Compensation and Pension (C&P) examination, one month after separation, the CI reported bilateral foot pain which increased with prolonged standing, walking on hard surfaces, and weight bearing. Physical examination showed a normal foot, ankle and gait.  Pain was noted with third toe motion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the each foot 10%, coded 5003-5279 (arthritis, degenerative - metatarsalgia, anterior). The PEB listed bilateral metatarsalgia as a Category II condition, a diagnosis related to the primary unfitting diagnosis and not separately ratable (IAW VASRD §4.14, avoidance of pyramiding). The VA also rated the each foot condition 10%, coded 5283 (malunion or nonunion of metatarsal bones), based on the C&P examination, citing malunion or nonunion of the tarsal or metatarsal bones with moderate symptoms, or painful motion. The panel noted that the highest rating for 5279 is 10%. The evidence did not support a rating for moderately severe metatarsal bone malunion for a 20% rating for each foot. 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 bilateral foot condition.

BOARD FINDINGS: In the matter of the bilateral foot 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.

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