RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2017-05310
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090306

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Basic Trainee, medically separated for “moderate right foot pain secondary to a healing fourth metatarsal fracture” with a disability rating of 10%.

CI CONTENTION:  “Veteran did not receive full separation physical.  No X-ray.  Veteran did not receive an accurate rating or review.  Veteran suffered and was not rated for depression or arthritis.  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 - 20090211	VARD - 20090514	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Moderate Right Foot Pain…	5284	10%	Fourth Metatarsal, Stress Fracture, Right Foot 	5284	10%	20090501	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Moderate Right Foot Pain Secondary to a Healing Fourth Metatarsal Fracture.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right foot condition began in August 2008 after sustaining a fall during basic training.  Initial radiologic imaging revealed a stress fracture of the right-sided fourth metatarsal bone.  A podiatry examination on 5 January 2009 revealed tenderness along the fourth metatarsal bone on the right foot.  The 26 January 2009 MEB NARSUM examination, one month prior to separation, noted complaints of daily right foot pain.  The CI also endorsed painful flare-ups lasting 2 to 3 days when stepping the wrong way.  Physical examination (PE) revealed a normal gait and stance despite the wearing a post-operative shoe.  There was right-sided fourth metatarsal bone tenderness.  Right ankle dorsiflexion was 20 degrees (normal) and plantar flexion was 48 degrees (normal 45).

At the 1 May 2009 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported intermittent right foot pain described as throbbing while walking.  PE revealed an abnormal gait whereby the CI avoided right foot flexing.  There was right fourth metatarsal tenderness and right foot painful motion.

The panel directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA rated the right foot condition 10%, coded 5284 (foot injury, other), citing “moderate” foot injury causing pain upon use IAW VASRD §§4.10, 4.40, 4.45, 4.59, and a moderate foot injury, respectively.  Panel members considered various VASRD codes to rate the single metatarsal condition.  The maximum rating for code 5279 (metatarsalgia) is 10%.  There was no malunion or nonunion of the metatarsal bone, at the time of separation, to support a rating under code 5283.  The panel considered the CI’s foot injury as moderate which supports a 10% rating.  Therefore, 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’s 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.

 
PD-2017-05310

ARXXXXXXXXXXX, XXXXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXXX

	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

	PD-2017-05310