RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX		CASE: PD-2017-03806 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060515

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Signal Support System Specialist, medically separated for “bilateral plantar fasciitis,” rated 10% each foot, with a combined disability rating of 20%.

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 - 20060403	VARD - 20071004	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Plantar Fasciitis	5399-5310	10%	Right Foot Plantar Fasciitis	5299-5284	10%	20070104	
		10%	Left Foot Plantar Fasciitis	5299-5284	10%		
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	
	
ANALYSIS SUMMARY:

Bilateral Plantar Fasciitis. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s plantar fasciitis began insidiously during basic training and continued thereafter. A bone scan in August 2004 demonstrated stress-related changes of the ankles and knees. Examination in September 2004 showed no pes planus (flat foot). A bone scan in October 2004 of the lower extremities was normal. Weight-bearing X-rays showed no bony abnormalities of either foot. Despite numerous temporary profiles, medications, physical therapy sessions and inserts, she continued to have foot pain and was unable to perform her duties.   During the      17 January 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI reported “foot trouble pain.”   Physical examination revealed a normal   arch.

No details were provided relative to the severity of the condition or whether it was asymptomatic or symptomatic.

The 7 February 2006 MEB NARSUM examination, 3 months prior to separation, noted complaints of debilitating foot pain made worse with all impact activities. Physical examination showed a mild antalgic gait favoring the right lower extremity and increased tenderness along the entire plantar fascia of both feet without any obvious deformity. Arches were normal and there was no edema, erythema, ecchymoses or hind foot valgus deformities of either foot. There was full active range of motion (ROM) of both ankle joints. Sensation was intact to light touch distally and bilaterally.  The examiner diagnosed bilateral plantar fasciitis.

At the 4 January 2007 VA Compensation and Pension (C&P) examination, 8 months after separation, the CI reported plantar fasciitis with arch pain. Physical examination showed bilateral foot tenderness, but there was no pes planus, pes cavus (high arch), hammer toes, hallux valgus (bunion), hallux rigidus or Morton’s metatarsalgia. She did not have any limitation with standing and walking and did not require any type of support with her shoes. Gross examination of all other joints and muscles of the feet were within normal limits. The bilateral ankles showed signs of tenderness, but there was no ankle deformity. The bilateral ankle ROM evaluation showed 20 degrees of dorsiflexion (normal) and 45 degrees of plantar flexion (normal) without pain or loss of motion on repetition.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left and right foot conditions 10% each foot, analogously coded 5399-5310 (muscle Group X (movements of forefoot and toes; propulsion thrust in walking)), citing moderate foot disabilities. The VA also rated the left and right foot conditions 10% each, analogously coded 5299-5284 (foot injury, other), based on the C&P examination citing functional impairment due to pain. The panel noted there was insufficient evidence to support a rating higer than 10% for either foot or both feet in the absence of acquired flatfoot (5276), bilateral weak foot (5277), acquired claw foot (5278), bilateral hallux valus (5280) or hallux rigidus (5281), malunion or nonunion of the tarsal or metatarsal bones (5283) or a known foot injury of either foot (5284). 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.

The following documentary evidence was considered:
PD-2017-03806 

AR20190010829, 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.

PD-2017-03806