Author: JOHN J. D'ORAZIO
Last saved by: Weathers, Janice R SrA MIL USAF AFDW SAF/MRBD
Company: Pre-installed Company

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	 CASE:  PD 13-01197	
BRANCH OF SERVICE:  Army	 BOARD DATE:  20140115
Date of Permanent SEPARATION:  20030816	

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (44E/Machinist) medically separated for bilateral foot pain.   His foot pain began in 1992 and he has had intermittent pain since then.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards.   He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB).  The bilateral foot condition, characterized as “chronic left and right foot pain (pes planus)” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The informal PEB adjudicated “bilateral foot pain” as unfitting, rated 10%.  The CI made no appeals, and was medically separated.

CI CONTENTION:  “I sacrificed 13 ½ yrs of my life nearing a retirement, my medical condition changed that and caused great hardships in my health both physically and mentally and financially.  My discharge disability of flat feet also led to additional problems such as knee and back problems, along with asthma, I’m forced to be much less active which in turn led to weight gain and depression.  In 2009 I was self admitted to the Army substance abuse program for chemical dependency where I was diagnosed with PTSD.  In 2010 after 7 years of civil service I was placed on the Priority Placement Program where I had requested for Florida.  In 2011 I was given one chance to accept Colorado or be unemployed.  I took it however after only a couple months I had to resign due to treatment altitude.”

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI.  The Service rating for the unfitting bilateral foot condition is addressed below; and, no additional conditions are within the DoDI 6040.44 defined purview of the Board.  The requested knee, back, weight gain, mental health, and substance abuse conditions were not identified by the PEB, and thus are not within the DoDI 6040.44 defined purview of the Board.  The Board acknowledges the CI’s information regarding the significant impairment with which his service-connected condition continues to burden him; but, must emphasize that the Military Disability Evaluation System (DES) has neither the role nor the authority to compensate service members for anticipated future severity or potential complications of conditions resulting in medical separation.  That role and authority is granted by Congress to the Department of Veteran Affairs (VA), operating under a different set of laws.  Any conditions or contention not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Army Board for Correction of Military Records (BCMR).

RATING COMPARISON:  
   
Service IPEB – Dated 20030205 | VA - based on Service Treatment Records (STR)
Condition | Code | Rating | Condition | Code | Rating | Exam
Bilateral Foot Pain | 5276 | 10% | Bilateral Pes Planus | 5276 | 10% | STR
No Additional MEB/PEB Entries | Other x 2 | STR
Combined:  10% | Combined:  10%
Derived from VA Rating Decision (VARD) dated 20030529 (most proximate to date of separation [DOS]).   

ANALYSIS SUMMARY:  

Bilateral Pes Planus Condition. The CI was first seen for flat feet (pes planus) on 30 January 2002 after a road march.  He was found to have bilateral pes planus on x-rays that day.  Previously, he had been treated for an ankle sprain and acute fracture of the foot.  He was issued orthotics, but continued to have pain with prolonged standing and running.  On 28 August 2002 he was noted to have also been diagnosed with bilateral plantar fasciitis.  He failed to improve adequately with conservative treatment and was entered into the DES process on 1 October 2002 and a P3 profile initiated.  The narrative summary (NARSUM) was dictated on 5 December 2002, eight months prior to separation.  The examiner noted that the CI had had problems with foot pain going back to 1992, but that he had done well until January 2001 (actually, 2002 per the records) when he aggravated his foot pain during a road march.  Conservative management was noted as insufficient for him to return to full duty.  On examination, he had obvious pes planus bilaterally with slight valgus heel and pronation.  He was tender over the tarsal navicular bilaterally, but no excessive callous formation.  He was found to have bilateral foot pain and pes planus.  The CI waived a VA compensation and pension (C&P) examination and the VA rated the condition based on the service treatment records.  The Board directed attention to its rating recommendation based on the above evidence.  The VA and PEB both coded the bilateral pes planus condition as 5276, acquired flat foot, and rated it at 10%.  The VA noted that a 10% rating is awarded when the weight bearing line is over or medial to the great toe with inward bowing of the tendo-achillis and pain on manipulation and use of the feet.  A higher, 30% rating is not warranted unless there is marked deformity, pain on manipulation and use (accentuated), swelling on use, and characteristic callouses.  The CI did not meet the criteria for a 30% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the bilateral anterior foot pain condition.  

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.  In the matter of the bilateral foot condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration. 

RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:  

UNFITTING CONDITION | VASRD CODE | RATING
Bilateral Foot Pain | 5276 | 10%
COMBINED | 10%

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20130905, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

			
	           				XXXXXXXXXXXXXXXXX, DAF
President
Physical Disability Board of Review

SFMR-RB									

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation forXXXXXXXXXXXXXXXXX, AR20140005204 (PD201301197)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a,   I accept the Board’s recommendation and hereby deny the individual’s application.  
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:

Encl						     XXXXXXXXXXXXXXXXXXX
						     Deputy Assistant Secretary
						         (Army Review Boards)

PD 13-01197