RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04432
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090705

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Motor Transport Operator, medically separated for “bilateral plantar fasciitis” with a 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 - 20090417	VARD - 20100803	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Plantar Fasciitis	5299-5284	10%	Bilateral Plantar Fasciitis	5276	10%	20091006	
		10%					
Overweight	Not Compensable	No VA Placement	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  50% 	

ANALYSIS SUMMARY:  

Bilateral Plantar Fasciitis.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s bilateral foot condition began in January 2006 with gradual onset.  The CI denied any specific injury or trauma.  In March 2008 he underwent surgery to correct a right fifth hammertoe deformity.  During the 7 October 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 9 months prior to separation, the CI reported occasional foot swelling with numbness.  Physical examination revealed mild symptomatic pes planus, but was otherwise unremarkable. 

During the 29 January 2009 MEB NARSUM examination, 5 months prior to separation, the CI complained of foot pain that was worse with cold weather.  He was unable to run or walk/stand for prolonged periods.  Physical examination revealed no swelling, inflammation or foot tenderness over the arches or plantar fascia.  Vascular and sensory function was intact bilaterally. There was no tenderness over the Achilles tendons, and the CI had “full” range of motion (ROM) of both ankles with dorsiflexion of 10 degrees (normal 20) and plantar flexion of 40 degrees (normal 45).  There was no ankle instability, tenderness or edema.  

At the 6 October 2009 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported bilateral foot numbness with use and progressively worse pain.  Physical examination revealed tenderness, swelling, painful motion of the bilateral feet and evidence of bilateral plantar fasciitis.  There was decreased bilateral ankle ROM with plantar flexion to 30 degrees.  There were normal reflexes, motor strength and sensation in the lower extremities.

At the 4 June 2010 C&P examination, 11 months after separation, the CI reported foot pain and swelling while walking, standing or at rest with lack of endurance while standing or walking.  Physical examination revealed no swelling, instability, weakness or abnormal weight bearing, but there was painful motion and tenderness in both feet.  X-rays showed a small superior calcaneal spur in each foot.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left and right foot conditions 10% each with a combined rating of 20%, analogously coded 5284 (foot injuries, other), citing moderate foot injuries.  The VA bundled the bilateral foot condition and rated it 10%, coded 5276 (acquired flatfoot), based on the 6 October 2009 C&P examination, citing pain upon manipulation and use of feet, abnormal weight bearing and evidence of plantar fasciitis.

Although the NARSUM showed no swelling, inflammation or foot tenderness, the C&P examination, proximal to separation, noted painful motion, tenderness and swelling, providing evidence of plantar fasciitis.  The panel agreed a 10% rating for each foot and no higher was justified for moderate foot injuries under code 5284 since there was no difference in the pathological findings of the right and left foot.  There was no evidence of marked deformity in either foot suggestive of severe pes planus that would provide a higher rating under code 5276.  The panel considered alternative VASRD foot and analogous codes, but all were less applicable and/or not advantageous to rating.  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:  Overweight.  The panel’s main charge is to assess the fairness of the PEB’s determination the overweight condition is not compensable.  The panel notes that being “overweight” is a condition not constituting a physical disability IAW DoDI 1332.38.  Therefore, the panel has no basis for recommending it as unfitting.  

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 overweight condition, the panel recommends no change from the PEB determination as not compensable.  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:

AR20180016638, 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.