RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXX	CASE: PD-2018-00432
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060708

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

CI CONTENTION:  Review of all conditions requested. 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 - 20060522	VARD - 20070301	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Foot/Heel Pain	5099-5003	10%	Right Calcaneal Spur	5299-5284	10%	20060930	
Right Wrist Pain	Not Unfitting	No VA Placement	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Chronic Right Foot/Heel Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s chronic right foot/heel pain began in October 2005 after sustaining an inversion injury while engaging in field training. Radiographs revealed a “tiny spur” on the back of the right heel. The 25 April 2006 MEB NARSUM examination, 3 months prior to separation, noted the CI’s chief complaint as “chronic right foot pain.” His physical examination (PE) revealed tenderness at the Achilles insertion about the right heel. There was no evidence of joint instability. Right ankle range of motion (ROM) was minimally decreased noting dorsiflexion

to 15 degrees (normal 20). Plantar flexion was normal. There was no comment concerning the presence of painful motion.

At the 30 September 2006 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported right heel pain aggravated by running, prolonged standing, or riding a bike. All parameters of the PE surrounding the right heel and foot, to include gait, were completely normal except for tenderness about the right heel.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right foot/heel condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing arthritis with loss of motion. The VA also rated the right foot condition 10%, analogously coded 5299-5284 (foot injuries; other) based on the C&P examination, citing radiologic evidence and pain on examination.

Panel members first agreed that the persistent evidence of heel tenderness would not justify a service rating IAW VASRD §4.59 (painful motion). Panel members then considered alternative ankle and analogous codes, but in the absence of limited joint motion, ankylosis, nonunion or malunion, or an injury of moderate severity, no VASRD §4.71a applicable code would yield a rating higher than the 10% rating 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 heel/foot condition.

Contended PEB Condition: Right Wrist Pain. The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. The contended condition was not profiled or implicated in the commander’s statement, and did not fail retention standards. 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.

BOARD FINDINGS: In the matter of the right foot/heel pain and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication. In the matter of the contended right wrist pain, the panel agrees it cannot recommend it for additional disability rating. 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.

2	PD-2018-00432
AR20190008492, 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.