RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXX	CASE: PD-2017-05130
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20050912

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, M1 Armor Crewman, medically separated for “right foot pain following excision of neuroma” with a disability rating of 10%.

CI CONTENTION: “Continued foot pain, inability to do any high impact activities.” 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 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 - 20050718	VARD – 20060609	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Foot Pain…	5099-5003	10%	Right Foot Painful Scar	5279-7804	10%	20060228	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Right Foot Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent an excision of a calcified venous plexus and evident neuroma of the right third end-metatarsal space in April 2004. Post-surgery, he had pain with walking. During the 23 November 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 10 months prior to separation, the CI reported foot pain after surgery and that he walked with a limp and could not run or jump. Physical examination revealed a linear 3-cm scar between the third and fourth digit on the right foot. The 10 December 2004 MEB NARSUM examination noted complaints of foot pain when walking, but none during rest. Physical examination showed no visible callus or skin lesions, and while the fourth toe had decreased sensation, all toes had good pedal pulses, and normal vascular flow. There was good muscle function and strength of toes and feet in all planes, and range of motion of the subtalar joint and metatarsal joint was “good without pain.” Ankle dorsiflexion and plantar flexion were adequate.

At the 28 February 2006 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported right foot weakness and fatigability. Physical examination showed a

2-inch scar with marked redness and broad stretching of the scar over the dorsum of the foot, and the third and fourth toes were anatomically in an abnormal position. His shoes did not show patterns of abnormal weight bearing.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right foot condition 10%, analogously coded 5099-5003 (arthritis, degenerative), citing application of the US Army Physical Disability Agency pain policy. The VA rated the right foot condition 10%, analogously coded 5279-7804 (metatarsalgia-scars, superficial), based on the C&P examination, citing a painful superficial scar and anterior metatarsalgia (Morton’s disease). Panel members considered VASRD code 5284 (foot injuries, other) for a 20% rating (moderately severe disability). Although the CI reported that he walked with a limp and had pain when walking in conventional shoes, he did not wear corrective devices in his shoes and there was no evidence of abnormal weight bearing or calluses. Therefore, the panel agreed that the condition did warrant a 20% rating. There were no additional applicable code that would result in a higher rating than that adjudicated by the PEB. 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 §4.71a, 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.

XXXXXXXXXXXXXXXXXXX. 

Dear XXXXXXXXXXXXXXXXXXXXXXX

	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.