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 XXXXXXXXXX Case Number PD-2020-00150.

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 Navy. 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, Aegis Operations Specialist, medically separated for “bilateral feet complex regional pain syndrome [CRPS],” rated 10% each, with a combined disability rating of 20%, and coded 5279 (metatarsalgia, anterior, unilateral or bilateral). The PEB also listed bilateral feet failed forefoot surgery as a related Category II condition that contributed to the primary unfitting condition but was not separately ratable. The impairment from the bilateral feet failed forefoot surgery was properly subsumed under the overall rating for the bilateral feet CRPS IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The VA rated the postoperative right second digit arthroplasty, third and fourth metatarsal Weil osteotomy and arthroplasty condition 20%, analogously coded 5278 (claw foot [pes cavus], acquired). The VA also rated
the postoperative left second and third digit foot capsulotomy condition 10%, analogously coded 5279. The panel first considered the evidence for the 10% rating of the left foot and agreed the 10% rating and no higher was justified based on pain that contributed to loss of ability to perform military occupational specialty duties. The narrative summary (NARSUM) indicated mild edema, and no signs of infection. The Compensation and Pension (C&P) examination, 1 month before separation, showed absence of swelling or tenderness, good alignment of the Achilles tendon, and no atrophy. Painful motion was seen on dorsiflexion and plantar flexion of the left second and third digit. However, limitation of motion was not reported.

Panel members next considered the right foot and noted identical findings with the exception of tenderness at the metatarsal head of digit three and four. There was no mention of a tender fascia. Although the CI walked with a slight limp but had an otherwise normal gait. He wore regular shoes and did not require an assistive device for ambulation. There was no evidence of drop foot deformity of either foot, no hammertoe deformity or Morton’s neuroma.
No hallux valgus or hallux rigidus. Panel members were unable to justify a higher rating under

code 5278 since there was no ankle limitation of motion, and hammertoes, painful callosities, dropped forefoot, abnormal plantar fascia, were all absent. There were no additional applicable codes that would result in a higher rating. The panel concluded, there was no evidence to support the higher than 10% rating adjudicated by the PEB based on the findings at the NARSUM and C&P examinations. 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 bilateral feet condition.

2	PD-2020-00150

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
6040
CORB: 001
10 Aug 2021

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

Subj:	Physical Disability Board of Review Determination Ref:	(a) 6040.44(Series)
1.	The Physical Disability Board of Review (PBDR) reviewed your case in accordance with reference
(a) and forwarded their recommendation for action.

2.	On 9 June 2021, the Assistant Secretary of the Navy (Manpower and Reserve Affairs) accepted the PDBR’s recommendation of no change to your characterization of separation or disability rating assigned.

3.	The PDBR determination is final and not subject to appeal or review.