RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX  	CASE:  PD-2017-04927
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041117

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Intelligence Analyst, medically separated for “chronic pain, right foot” with a disability rating of 10%.   

CI CONTENTION:  Review requested of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB). 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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20040928	VARD – NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain, Right Foot	5099-5003	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Right Foot Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent a right plantar fascial release surgery in 1999 and tarsal tunnel release in 2000.  Neither procedure provided relief of pain symptoms.

The 2 August 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, revealed well-healed scars behind the right medial malleolus, and tenderness on medial side of the heel and in the plantar fascia.  There was “full” range of motion (ROM) and decreased sensation on the medial side of the heel.  

During the 9 September 2004 MEB NARSUM examination, 2 months before separation, the CI complained of constant pain, rated at 7/10, and could only walk up to one mile before stopping due to pain.  Physical examination showed normal pedal pulses, and no edema or redness of the foot or ankle.  There was tenderness to the tarsal tunnel and entire plantar fascia, and light tapping of the tunnel canal elicited shooting pain throughout the tarsal tunnel.  Radiographic imaging showed no evidence of fracture or bone infection, and normal foot morphology.  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 right foot condition 10%, analogously coded 5003 (arthritis, degenerative), citing slight and constant pain IAW the US Army Physical Disability Agency pain policy.  Members noted there was no limitation of motion which attained a 10% rating under the diagnostic codes for limitation of ankle flexion (5271) or evidence of claw foot (5278).  The panel also noted a higher rating was not justified under code 5284 (foot injuries, other).  Therefore, there was no available rating higher than the 10% PEB rating under any applicable code.  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 right foot condition.  

BOARD FINDINGS:  In the matter of the chronic right foot pain and IAW VASRD §4.712 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.  

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.

Sincerely,					       

Enclosure