RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200503 SEPARATION DATE: 20010930 

BOARD DATE: 20130220 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (63H/Tracked Vehicle Mechanic), medically 
separated for a bilateral foot condition. She developed foot pain in early 2000 and was 
diagnosed with bilateral bunions, eventually requiring bilateral bunionectomies. She did not 
respond adequately to treatment to meet the physical requirements of her Military 
Occupational Specialty. She was issued a permanent L3 profile and referred for a Medical 
Evaluation Board (MEB). The foot condition was forwarded to the Physical Evaluation Board 
(PEB) as medically unacceptable IAW AR 40-501. Four other conditions (as identified in the 
rating chart below) were addressed by the MEB and also forwarded to the PEB as not meeting 
retention standards. Of these, only the low back pain (LBP) had been noted on the narrative 
summary (NARSUM) as failing to meet retention standards. The PEB adjudicated the bilateral 
foot condition as unfitting, rated 10%, citing criteria of the Veterans Affairs Schedule for Rating 
Disabilities (VASRD). The remaining conditions were determined to be not unfitting. The CI 
made no appeals and was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: “fibroids in uterus has led to hysterectomy. Scar on right foot has constant 
pain and foot hurts. Long term standing more than 10 mins bothers back, feet & legs. Last job I 
had to leave due to back pain and having to help left clients when transporting. Also was 
previously denied condition allergic rhinitis. I had to quit job as we due to environmental 
conditions at the same job. I have headaches daily my migraine cause nausea and I have to 
take topax twice a day to keep from having the aural portion of the migraine and the more 
severe pain. *Note you will see I was denied for some conditions.”(sic) 

 

 

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 rating for the unfitting bilateral foot 
condition is addressed below. The requested not unfitting back pain, seasonal allergies, and 
cervical dysplasia conditions are within the scope of this Board. The not unfitting hypertension 
condition was not requested for review and is thus not within the defined scope. The migraine 
headache condition was not considered by the PEB and is therefore outside the scope of the 
Board. 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 
Corrections of Military Records. The Board acknowledges the CI’s information regarding the 
significant impairment with which her service-connected conditions continue to burden her; 
but, it must emphasize that the Disability Evaluation System has neither the role nor the 
authority to compensate members for anticipated future severity or potential complications of 
conditions which resulted in medical separation. That role and authority is granted by Congress 
to the Department of Veterans Affairs (DVA), operating under a different set of laws. The Board 
considers DVA evidence proximate to separation in arriving at its recommendations; and, DoDI 
6040.44 defines a 12-month interval for special consideration to post-separation evidence. 
Post-separation evidence is probative to the Board’s recommendations only to the extent that 
it reasonably reflects the disability at separation. The Board likewise acknowledges the CI’s 


contention for rating of the various conditions noted above which were determined to be not 
unfitting by the PEB and emphasizes that disability compensation may only be offered for those 
conditions that cut short the member’s service career. Should the Board judge that any 
contested condition was most likely incompatible with the specific duty requirements, a 
disability rating will be recommended IAW the VASRD and based on the degree of disability 
evidenced at separation. 

 

 

RATING COMPARISON: 

 

Service PEB – Dated 20010731 

VA - (3 Mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Bilateral Metatarsal Pain 
s/p Bunionectomy 

5299-5279 

10% 

S/P Bunionectomy, Left Foot 

5280 

10% 

20020114 

S/P Bunionectomy, Right Foot 

5280 

10% 

20020114 

Chronic Low Back Pain 

Not Unfitting 

Chronic Low Back Sprain 

5295 

10% 

20020114 

Seasonal Allergic Rhinitis 

Not Unfitting 

Allergic Rhinitis 

6522 

NSC 

20020114 

Hypertension 

Not Unfitting 

Hypertension 

7101 

0% 

20020114 

Cervical Dysplasia 

Not Unfitting 

Fibroids 

7615 

10% 

20020104 

No Additional MEB/PEB Entries 

Other x 10 

20020114 

Combined: 10% 

Combined: 40% 



VARD 20021221 most proximate to date of separation. 

 

 

ANALYSIS SUMMARY: 

 

Bilateral Foot Condition. The first recorded visit for bilateral foot pain was on 28 January 2000 
when she was diagnosed with bilateral bunions (hallux valgus). Conservative management was 
not adequate and she underwent bilateral bunionectomies. She had persistent pain in the right 
foot which led to a revision of the right great toe with revision of the soft tissue and an 
osteophyte. She continued to have pain which precluded meeting fully duty requirements and 
was issued a permanent L3 profile and referred to MEB. The NARSUM dictated on 18 July 2001, 
2 months prior to separation. The CI reported bilateral foot pain as well as LBP. On 
examination, the left foot showed successful treatment of the hallux valgus condition after 
surgery. Dorsiflexion was 40 degrees and plantar flexion was 25 degrees. No tenderness was 
noted. The right great toe showed mild crepitus in flexion with 40 degrees of dorsiflexion and 
10 degrees of plantar flexion. There was some dorsal tenderness over the joint (toe to foot). 
The scars were well healed and non-tender although there was still ongoing healing. At the VA 
Compensation and Pension (C&P) examination on 14 January 2002, 3 months after separation, 
the CI reported continued pain if she stood for long periods of time, but did not wear special 
shoes or even the recommended tennis shoes or sandals. She denied swelling and took no 
medications for pain. On examination, the gait was normal. She was able to walk on her heels, 
but had difficulty walking on her toes or the outside of her feet due to pain. The right foot 
showed hallux valgus which was not documented on the left. The scars on both feet were non-
tender. The range-of-motion (ROM) of the feet was noted to be “good.” X-rays were normal 
other than bilateral mild hammer toes of the second and third digits; this is a separate 
condition from the bilateral hallux valgus. The Board noted that the PEB combined the left and 
right bunionectomies into a single unfitting condition rated at 10% utilizing the VASRD code 
5279 for metatarsalgia. Although the right great toe was the more symptomatic, both were 
surgically treated, profiled and noted to limit duty. The Board determined that each great toe, 
status post bunionectomy, was separately unfitting. 

 

The Board then directed its attention to the rating recommendation based on the above 
evidence. The PEB combined the bilateral bunion condition into a single unfitting condition 
rated at 10% and coded 5279, metatarsalgia, the maximum under this coding option. The VA 
rated each toe separately at 10% and coded them 5280, hallux valgus, for a combined rating of 


20%. The Board determined that this coding option is a more accurate option than the 5279 
code utilized by the PEB and also provided a rating advantage to the CI. After due deliberation, 
considering all of the evidence and mindful of VASRD §4.3 (Resolution of reasonable doubt), the 
Board recommends a disability rating of 10% each for the bilateral hallux valgus conditions, 
coded 5280. 

 

Contended PEB Conditions. The Board’s main charge is to assess the fairness of the PEB’s 
determination that the LBP, seasonal allergic allergies (SAR) and history of cervical dysplasia 
were not unfitting. The Board’s threshold for countering fitness determinations is higher than 
the VASRD §4.3 (Resolution of reasonable doubt) standard used for its rating 
recommendations, but remains adherent to the DoDI 6040.44 “fair and equitable” standard. 
Only the LBP was profiled and judged to fail retention standards; none were directly implicated 
in the commander’s statement. All were reviewed by the action officer and considered by the 
Board. The examination of the back showed mild tenderness to palpation with reduced flexion 
on the NARSUM but normal ROM on the C&P examination; SAR was well controlled with 
medications; the cervical dysplasia was treated by cone biopsy during a break in service and 
subsequent testing was normal. There was no performance based evidence from the record 
that any of these conditions significantly interfered with satisfactory duty performance. After 
due deliberation in consideration of the preponderance of the evidence, the Board concluded 
that there was insufficient cause to recommend a change in the PEB fitness determination for 
any of the contended conditions and so no additional disability ratings are recommended. 

 

 

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 hallux valgus conditions, the Board unanimously 
recommends a disability rating of 10% each, coded 5280 IAW VASRD §4.71a. In the matter of 
the contended LBP, SAR and cervical dysplasia conditions, the Board unanimously recommends 
no change from the PEB determinations as not unfitting. There were no other conditions within 
the Board’s scope of review for consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of her prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Left Hallux Valgus with Metatarsal-Phalangeal Pain 

5280 

10% 

Right Hallux Valgus with Metatarsal-Phalangeal Pain 

5280 

10% 

COMBINED (w/ BLF) 

20% 



 

 

 

 

 

 

 

 

 

 

 

 


The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120602, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

 XXXXXXXXXXXXXXXXXX, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / XXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for XXXXXXXXXXXXXX, AR20130006075 (PD201200503) 

 

 

1. 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 to modify the individual’s disability rating to 20% 
without recharacterization of the individual’s separation. This decision is final. 

 

2. I direct that all the Department of the Army records of the individual concerned be 
corrected accordingly no later than 120 days from the date of this memorandum. 

 

3. I request that a copy of the corrections and any related correspondence be provided 
to the individual concerned, counsel (if any), any Members of Congress who have 
shown interest, and to the Army Review Boards Agency with a copy of this 
memorandum without enclosures. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl XXXXXXXXXXXXXXXXXX 

 Deputy Assistant Secretary 

 (Army Review Boards)