RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXX	CASE:  PD-2021-00076
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060530

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Administration Specialist, medically separated for “right hallux limitus” with a disability rating of 10%.   

CI CONTENTION:  The CI’s application  included an eight page statement submitted by his counsel.  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 - 20060213	VARD - 20070305	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hallux Limitus	5299-5281	10%	Degenerative Joint Disease of the First MTP Joint of the Right Great Toe…	5010-5281	10%	20061121	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Hallux Limitus.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent right toe cheilectomy in May 2004, but continued to have pain with running or wearing boots.

The 25 October 2005 MEB NARSUM examination, 8 months prior to separation, noted complaints of “pain and stiffness to the right first metatarsophalangeal joint and hallux interphalangeal joint.”  Physical examination showed “neurovascular status intact with tenderness to palpation on the dorsal aspect of the first metatarsophalangeal joint and hallux interphalangeal joint and medial to the extensor hallucis longus tendon and the medial first metatarsophalangeal joint.”  The surgical incision was well healed.  There was 0 degrees of dorsiflexion at the first metatarsophalangeal joint of the right foot and “hypermobility at the hallux interphalangeal joint with greater than 10 degrees of dorsiflexion and full range of plantar flexion with mild crepitus.”  He also had “a pes planus foot type that increased the navicular drop on weight bearing.  X-rays showed severe joint space narrowing, spurring, and osteophyte formation on the back of the first metatarso-phalangeal joint.  

During the 16 November 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 7 months prior to separation, the CI reported having foot trouble.  Physical examination revealed reduced range of motion (ROM) of the right great toe, but foot arch was noted to be normal.

At the 21 November 2006 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported almost no ROM and daily pain from baseline of 2/10 to 7/10 with prolonged standing.  Physical examination showed 0 degrees of dorsiflexion of the right great toe, but he could plantar flex all his toes 5 degrees.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right great toe condition 10%, analogously coded 5299-5281 (hallux rigidus).  The VA also rated the right great toe condition 10%, dual coded 5010-5281 (traumatic arthritis causing hallux rigidus).

The panel members agreed, the 10% rating and no higher was justified for the condition of the right great toe.  There was no appropriate code for the condition that would result in higher than a 10% rating.

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 great toe condition.  

BOARD FINDINGS:  In the matter of the right great toe condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  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.   

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20210528, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20220000358, XXXXXXXXXXXXX

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.

	A copy of this decision has been provided to the counsel you listed on your application, XXXXXXXXXXXXXXXXXXXXXXX

Sincerely,