RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01625
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090824

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an  active duty E2, Petroleum Supply Specialist, medically separated for “bilateral congenital rigid pes planus,” rated 10% each foot, with a combined disability rating of 20%.  

CI CONTENTION:  In addition to his bilateral foot condition, the CI requested review of his neck condition.  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 - 20090421	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Congenital Rigid Pes Planus	5299-5276	10%  	No VA Examination Proximate to Separation in Evidence	
		10%		
Cervical Disk Disease	Not Unfitting		
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Bilateral Congenital Rigid Pes Planus.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s bilateral foot condition began in late summer of 2006 without trauma or injury.  He was diagnosed with pes planus.  In August 2007 he underwent a left hallux bunionectomy with internal fixation and a percutaneous Achilles tendon lengthening.  Post-surgical X-rays of the left foot revealed the bunionectomy with good healing, degenerative changes of the first metatarsal phalangeal (MTP) joint, small plantar heel spur and a large os trigonum.  X-rays of the right foot showed degenerative changes of the first MTP joint with bunion and mild degenerative changes at the second distal interphalangeal joint.  There was also severe left greater than right pes planus.  

At the 24 July 2008 podiatry examination, the CI complained of bilateral foot pain causing difficulty walking, especially in military boots.  Physical examinations showed a normal gait and stance.  There were bilateral decreased medial longitudinal arches, excessive pronation and rigid (congenital) pes planus.  The CI exhibited tenderness of the medial plantar aspect of the heel, plantar aponeurosis and medial longitudinal arch.  Range of motion (ROM) testing of the feet showed pain at the extreme limits of ROM, but there was full painless ROM of the toes.  Skin and sensation were normal.  Ankle dorsiflexion was to 15 degrees, and the left foot scar was non-tender.  

During the 13 August 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 12 months prior to separation, the CI reported stable 4/10 foot pain increasing to 8-10/10 with activity.  Physical examination revealed pes planus with tenderness.  The 17 October 2008 MEB NARSUM examination, 10 months prior to separation, noted complaints of bilateral foot pain.  Physical examination showed severe symptomatic pes planus.  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 bilateral foot condition 20% (10% each foot), analogously coded 5299-5276 (acquired flat foot (pes planus)), citing “moderate” disability bilaterally.  Examinations documented pain on use of the feet not relieved by built-up shoe or arch support and evidence of pronation and severe flattening of the arch (which does not equate to the severe criteria under VASRD code 5276).  There was no evidence of pain on manipulation and use accentuated, indication of swelling on use or characteristic callosities to support the next higher “severe” VASRD rating for either 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.  

Contended PEB Condition:  Cervical Disk Disease.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was profiled (U2), but was not implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  Although the CI contended that his neck ROM was not correctly recorded on the 25 March 2009 MEB addendum, the panel notes that ROM was not a significant factor in the fitness determination for this case.  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.  

BOARD FINDINGS:  In the matter of the bilateral foot condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended neck condition, the panel recommends no change from the PEB determination as not unfitting.  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.  

AR20180015079, 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.