RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXX	CASE: PD-2020-00205
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20050922

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Navy Recruiter Canvasser, medically separated for right and left foot “pes cavus, symptomatic” rated 0% each, with a combined disability rating of 0%.

CI CONTENTION: He should have been medically retired (from TDRL) as a sailor in 2005, and TDRL should be backdated from September of 2005 until December 2006. He hopes to be reimbursed for the 15 months that he was out. 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. In this case, the CI is eligible, but the PDBR can only review his request for unfitting conditions at the time of separation.

RATING COMPARISON:

SERVICE PEB - 20050615	VARD - 20060210	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Pes Cavus, Symptomatic	5299-5003	0%	Right Pes Cavus, Metatarsalgia, Plantar fasciitis, Calcaneal Spurs	5284-5278	10%	20050804	
Plantar Fasciitis	Cat II	Left pes Cavus, Metatarsalgia, Plantar fasciitis, Calcaneal Spurs	5284-5278	10%	20050804	
Metatarsalgia						
Calf Contracture	Cat II	No VA Placement	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Pes Cavus. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s pes cavus was noted in April 2005 with complaints of pain in his arches and metatarsal heads, and also a ''numb tingly feeling to bilateral feet.”

The 28 April 2005 MEB NARSUM examination, 5 months prior to separation, recorded CI complaints of considerable pain when standing for more than 20 minutes at a time as well as pain with running. Physical examination of both feet showed mild to minimal tenderness, normal warmth and color, intact skin and pulses, and some fine varicosities, but no edema.

Although the 4 August 2005 VA Compensation and Pension (C&P) examination (1 month before separation) was not in evidence, the 10 February 2006 VA rating decision included excerpts from the examination and noted CI reports of foot pain aggravated by activity and that he wore orthotics. The examiner documented moderate to severe bilateral pes cavus deformities with plantar fascial pain, metatarsal region tenderness, and no hammer or claw toes; sensation was intact and X-rays were normal. Bilateral ankle range of motion (ROM) showed dorsiflexion to 15 degrees (normal 20) and plantar flexion to 45 degrees (normal). Joint function was not additionally limited by pain, fatigue, weakness, lack of endurance, or incoordination after repetition.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left and right foot conditions 0% each, analogously coded 5299-5003 (degenerative arthritis), and listed plantar fasciitis, metatarsalgia and calf contracture as related diagnoses (Category II) contributing to the disability in this case. The VA rated the left and right foot conditions 10% each, dual coded 5284-5278 (foot injuries, other-claw foot (pes cavus), acquired), based on the C&P examination. Panel members agreed that a 10% rating under code 5278 was warranted for mild bilateral limitation of dorsiflexion and metatarsal region tenderness, as documented at the C&P examination. The panel considered other VASRD foot and analogous codes, but all were less applicable and not advantageous for rating. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the pes cavus, coded 5278.

Contended PEB Conditions: Plantar Fasciitis, Metatarsalgia and Calf Contracture. The panel assessed whether the contended conditions were reasonably justified as separately unfitting for rating consideration, noting that they were listed on the CI’s limited duty report. The NARSUM examiner did not report any calf abnormality during the physical examination, and the STR did not demonstrate a specific disability related to the calf contracture alone. The 22 May 2006 examination, 8 months after separation, noted the CI’s plantar fasciitis symptoms had completely resolved. He was seeking a return to duty and indicated no difficulty, limitations, or disability related to his feet. Panel members concluded there was not a preponderance of evidence showing that any of the contended conditions standing alone would have caused the CI to be referred into the Disability Evaluation System or be found unfit. Therefore, the panel concluded there were no separate conditions that rendered the CI unfit. After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended conditions, so no additional disability ratings are recommended.

BOARD FINDINGS: In the matter of the pes cavus, the panel recommends a disability rating of 10%, coded 5278 IAW VASRD §4.72. In the matter of the contended plantar fasciitis, metatarsalgia, and calf contracture, the panel recommends no change from the PEB determinations as not unfitting. 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	
Bilateral Pes Cavus	5278	10%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20200928, w/atchs Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Record

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
7 March 2022

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

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 3 Mar 2022, the Assistant Secretary of the Navy (Manpower and Reserve Affairs) accepted the of an entitlement to disability separation pay with a 10 percent disability
rating. This decision was then sent to Navy Personnel Command for appropriate action.

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