RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01079
BRANCH OF SERVICE:  air force 	SEPARATION DATE:  20070412

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4, Aircraft Armament Systems Journeyman, medically separated for “bilateral foot pain,” rated 10% for the left foot and 10% for the right foot, with a combined 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 - 20070216	VARD - 20071101	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Foot Pain Right Foot	5399-5310	10%	Bilateral Pes Planus	5276	10%	20070531	
Bilateral Foot Pain Left Foot	5399-5310	10%					
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS: 40% 	

ANALYSIS SUMMARY:  

Bilateral Foot Pain (Left and Right Foot rated separately by PEB).  According to service treatment record and MEB narrative summary (NARSUM), the CI’s bilateral foot pain condition began in 2003 after running.  She was unable to participate in the physical readiness test or deploy.  Conservative treatment over the next four years included repeated evaluations, physical therapy, and foot inserts.  At a 14 November 2006 podiatry appointment, the CI reported foot pain with exercise.  The examiner noted fallen arches.  The rest of the examination was unremarkable.  

At the 31 May 2007 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported daily foot pain aggravated by prolonged walking or running and relieved with rest.  She stated that the foot pain did not interfere with her usual daily activities.  Radiographic examination indicated mild pes planus bilaterally.  Examination revealed flat feet bilaterally. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral foot pain condition 10% for each foot, analogously coded 5399-5310 for each foot, (muscle injury, group X), with a combined disability of 20%.  The PEB cited DoD and VASRD guidelines in making its determination.  The VA rated the bilateral foot pain condition 10%, coded 5276 (flatfoot, acquired), based on the C&P examination, citing the weight-bearing line is over or medial to the great toe with inward bowing of the tendo achilles, and there is pain on manipulation and use of the feet.  The panel noted that IAW VASRD §4.71a, flat foot, acquired or pes planus, coded 5276, has specific ratings for unilateral and bilateral conditions.  Panel members agreed that there was no route to a higher than 10% rating for each foot.  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 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.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170803, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-01079.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						Sincerely,

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings