DEPARTMENT OF THE AIR FORCE
WASHINGTON DC

Office of the Assistant Secretary

SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

MEMORANDUM FOR THE ASSISTANT SECRETARY OF THE NAVY, MANPOWER AND RESERVE AFFAIRS

SUBJECT: Physical Disability Board of Review Recommendation on Case Number PD-2018-00071

In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual from the United States Marine Corps. After carefully reviewing the application and medical separation case file, the PDBR recommended no re- characterization of the separation or modification of the disability rating previously assigned. I recommend you accept this proposed decision.

The covered individual (CI) was an active duty E5, Light Armored Vehicle Crewman, medically separated for “right foot crush injury” with a disability rating of 20%. The PEB dual coded 5284-5003 (foot injuries, other- degenerative arthritis) and also listed right foot neuropathic pain and lower limb mononeuritis as related Category II conditions that contributed
to the primary unfitting condition but were not separately ratable IAW VASRD §4.14 (avoidance of pyramiding). Therefore, the impairment from the right foot neuropathic pain and lower limb mononeuritis were properly subsumed under the overall rating for the right foot crush injury.
The VA rated the right foot condition 30%, dual coded 7804-5284 (scar, unstable or painful-foot injuries, other), based on the Compensation and Pension (C&P) examination, citing severe symptoms. Panel members agreed, the 5284 code was most reflective of the injury and a rating higher than the 20% (moderately severe) assigned by the PEB was not warranted. Panel members agreed the C&P examination was too remote from separation to offer significant probative value; however, that examination was relatively normal in its objective findings of right foot impairment. The panel considered alternative VASRD muscle and alternative codes, but all were less applicable and/or not advantageous for rating. There were no additional applicable codes that would result in a higher rating. The panel concluded, although the 5284 code was most applicable, a change in code represented no benefit to the CI. 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.

In the matter of the contended post-traumatic stress disorder (PTSD), the panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. The July 2005 psychotherapy note recorded the CI’s desire to train recruits and

eventually join “special forces.” The MEB addendum, 3 months prior to separation, documented a normal mental status examination, and noted PTSD symptoms were improving with
medication. The examiner noted that the CI “suffers from conditions which should be taken into consideration by the PEB,” but failed to list PTSD as stressor. The psychiatry consult, one month prior to the MEB addendum, noted the CI had presented to the emergency department with complaint of coping difficulties. He was evaluated and found to have a normal mental status examination and absence of suicidal ideation. He was deemed fit for full duty. The PTSD condition was not listed on the MEB. Treatment records were scarce, but the record reflected that the CI worked for the Department of Energy full-time in 2006 protecting nuclear weapons. He also worked full-time in 2007. There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation. After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.

2	PD-2018-00071

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO :
1850
CORB: 003
10 Sep20

From: Director, Secretary of the Navy Council of Review Boards To:

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no 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.