RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2019-00405
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20050916

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Aerospace Control and Warning Systems Journeyman, medically separated for “bilateral plantar fasciitis associated with pes planus, left greater than right” rated 10% and 0%, respectively, with a combined disability rating of 10%.  

CI CONTENTION:  Review all conditions.  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 - 20050708	VARD - 20060330	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Plantar Fasciitis	5310-5399	10%	Pes Planus, Bilateral Feet	5276	10%	20051130	
Right Plantar Fasciitis	5310-5399	0%					
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY: 
 
Left and Right Plantar Fasciitis.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI began experiencing bilateral foot pain in July 2004.  The 3 March 2005 MEB NARSUM examination, 6 months prior to separation, noted bilateral foot pain that was refractory to conservative treatment to include orthotic devices.  The CI reported modifying her day-to-day activity by limiting her standing to 30 minutes and ambulating to 2 blocks.  Physical examination showed significant bilateral pes planus, but no joint abnormalities or deformities.  Radiology confirmed bilateral pes planus.  At the 30 November 2005 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported acquired flatfeet.  Physical examination showed flattening of the medial plantar arches, but no erythema, swelling or abnormalities of the feet.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left foot 10% (moderate) and right foot 0% (slight), both analogously coded 5310 (Group X intrinsic muscles of the foot).  The VA rated the bilateral foot condition 10%, coded 5276 (flatfoot, acquired), based on the C&P examination, citing evidence of pain on manipulation and use of the feet.  The CI indicated significant bilateral foot pain while running, performing high impact activities or prolonged standing.  The MEB NARSUM examiner documented significant bilateral foot pain that was refractory to conservative treatment to include orthotic devices.  The CI reported modifying her day-to-day activity by limiting her standing to 30 minutes and ambulating to 2 blocks.  The panel majority agreed that the preponderance of STR and VA evidence showed functional impairment of each foot approximating moderate muscle injuries.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel majority recommends a disability rating of 10% for each foot coded 5399-5310.

Contended PEB Condition:  Irritable Bowel Syndrome.  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 left foot condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the right foot condition and IAW VASRD §4.71a, the panel majority recommends a disability rating of 10%, coded 5399-5310.  The single voter for dissent recommended no change but did not elect to submit a minority opinion.  In the matter of the contended irritable bowel syndrome, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Left Plantar Fasciitis	5399-5310	10%	
Right Plantar Fasciitis	5399-5310	10%	
COMBINED	20%	

The following documentary evidence was considered:

SAF/MRB 
3351 Celmers Lane 
JBA NAF Washington, MD 20762-6435 
 
Dear XXXXXXXXXXX: 

 Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2019-00405. 

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was not in accordance with the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended modification of your assigned disability rating without re-characterization of your separation with severance pay.  

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding, accept the recommendation and direct that your records be corrected as set forth in the attached copy of a Memorandum for the Chief of Staff, United States Air Force.  This will not result in any change to your separation documents or the amount of severance pay you are entitled to.  Disability severance pay is computed the same regardless of a rating of 0, 10 or 20 percent.