RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXX	CASE: PD-2017-04129
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20080930

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Aerographer’s Mate Striker, medically separated for “status post [S/P] flat foot reconstruction” with a disability rating of 20%.

CI CONTENTION: “The PEB should have also rated the left foot. 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 - 20080627	VARD - 20090622	
Condition	Code	Rating	Condition	Code	Rating	Exam	
S/P Flat Foot Reconstruction	5276	20%	Pes Planus Right Foot, S/P Surgery	5276	10%	20081215	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Right Flat Foot Reconstruction. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent surgery for right foot reconstruction in April 2007. The 2005 military entrance physical did not reference pes planus. The May 2007 limited duty (LIMDU) form recommended a desk job and limited physical activity. However, the right foot pain persisted; custom orthotics were ordered, but provided no significant reduction in foot pain.

The 30 May 2008 MEB NARSUM examination, 4 months prior to separation, noted continued right foot pain. The CI had limitations in performing physical activities. Radiographically, the CI showed surgical changes of the first metatarsal and calcaneus.  Although there was pes  planus,

the foot was anatomically aligned and there was no evidence of hardware loosening. Physical examination showed tenderness along the surgical scar and the bottom of the foot and the CI walked with a limp. Strength was normal (5/5) in all muscle groups and there was no limitation of motion of the ankle, but there was limited range of motion (ROM) in the metatarsal and subtalar joints.

At the 15 December 2008 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported bilateral foot pain elicited by physical activity and standing along with swelling and stiffness in the right foot while at rest, and pain and swelling while standing or walking. The CI also reported the inability to stand for more than 15 minutes and that daily activities increased the foot pain. Physical examination showed a normal gait and tenderness, but no swelling, weakness, atrophy or instability. Right and left ankle ROM testing showed dorsiflexion of 20 degrees (normal) and planatar flexion of 45 degrees (normal). There was active motion in the metatarsophalangeal joint of the right great toe. Both feet showed deformity of marked pronation, but there was no limitation with standing or walking. The CI did not require any type of support with her shoes.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right foot condition 20%, coded 5276 (acquired flatfoot, severe, unilateral). The VA rated the right foot condition 10%, coded 5276, based on the C&P examination, citing moderate symptoms.

Panel members agreed there was no evidence of claw foot (5278) or severe hallux valgus (5280) in the right foot to justify a rating under those respective codes. There was no evidence of hammer toe (5282), fractures with malunion or nonunion (5283) or injuries to the right foot that could be characterized as severe (5284) to validate ratings under those codes. There was no evidence of pronounced injury to the right foot to substantiate a 30% rating using code 5276 which specifies unilateral (one 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 right foot condition.

BOARD FINDINGS: In the matter of the right foot condition and IAW VASRD §4.71, 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:

2	PD-2017-04129

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 

IN   REPLY  REFER  TO:
1850
CORB: 003 20May20

From: 

Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW  (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 18 Jul 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno 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.