RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXX CASE: PD1200737 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130315 

SEPARATION DATE: 20030707 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was a National Guard PV2/E-2 (62J/General Construction Equipment 
Operator) medically separated for a bilateral condition. He developed bilateral chronic heel 
pain, associated with military footwear, in 1998; and, after a protracted trial of conservative 
and surgical podiatric interventions, 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 L4 profile and referred for a Medical Evaluation 
Board (MEB). The condition, characterized as “chronic foot pain, bilateral”, was forwarded to 
the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the 
MEB. The Informal PEB (IPEB) adjudicated the bilateral MEB submission as separately unfitting 
right and left foot conditions (with surgical residuals elaborated); rated 10% each, citing criteria 
of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The CI made no appeals, and 
was medically separated with a 20% combined disability rating. 

 

 

CI CONTENTION: “I have had 5 surgeries on my feet, with no positive results. All doctors I have 
seen since then have stated that there is nothing else they can do at this time other than give 
me medication for the pain. I will be on medication for the remainder of my life. I am now 
experiencing joint deterioration in my knees, hips and ankles due to the way I walk because of 
my feet. It is painful to be on my feet but I endure the pain and work so that I can help support 
my family.” 

 

 

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 ratings for the unfitting foot (encompassing 
ankle) conditions are addressed below. The associated knee and hip conditions, as per the 
contention, were not identified by the PEB; and, thus are not within the DoDI 6040.44 defined 
purview of the Board. Those, and any other conditions or contention not requested in this 
application, remain eligible for future consideration by the Army Board for Correction of 
Military Records. The Board acknowledges the CI’s information regarding the significant 
impairment with which his service-connected conditions continue to burden him; but, 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 
resulting in medical separation. That role and authority is granted by Congress to the 
Department of Veterans Affairs, operating under a different set of laws. 

 

 

 


RATING COMPARISON: 

 

Service IPEB – Dated 20030520 

VA – Service Treatment Records (STR) and Civilian Records* 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Bilateral Foot Pain, Surgical 
Residuals 

8799-8725 

10% 

Bilateral Tarsal Tunnel 
Syndrome 

8525 

NSC 

STR/Civilian 

10% 

No Additional MEB/PEB Entries 

Other x 1 – Also Not Service Connected (NSC) 

STR/Civilian 

Combined: 20% 

Combined: NSC 



 *Derived from VA Rating Decision (VARD) dated 20040930. No VA exam performed since the VA did not service connect the 

 CI’s two disability claims. VA also did not have access to National Guard Service Treatment Records, and utilized private 

 medical records and available STR evidence. Subsequent VA Rating Determination following receipt of STRs was unchanged. 

 

 

ANALYSIS SUMMARY: The PEB adjudicated each foot as service-incurred or permanantely 
aggravated, unfitting and rated at 10% each with no deduction for any pre-existing condition. 
Entry exams documented no foot pathology or disability. This Board will therefore focus only 
on the disability rating of each foot at the date of separation and not causation or service- 
connection. 

 

Bilateral Feet Pain Condition. The narrative summary (NARSUM) and MEB from the attending 
surgeon 2 months prior to separation was followed by a podiatry NARSUM and detailed the CI’s 
history as summarized above. Right foot surgey included a plantar fascia release and two tarsal 
tunnel releases. Left foot surgery was a tarsal tunnel release. The CI was on narcotic pain 
medication and had pain “rated as a constant marked pain by the AMA guidelines.” Exam 
documented an antalgic gait with bilateral ankle range-of-motion (ROM) of dorsiflexion 10 
degrees (normal 20 degrees), plantar flexion 40 degrees (normal 45 degrees), eversion of 5 
degrees and inversion of 10 degrees. Sensation was intact and there were bilateral 
posteromedial curvilinear scars that were hypersensitive. The diagnosis was bilateral chronic 
heel pain. The podiatry exam was proximate to the official NARSUM and exam indicated 
“curvilinear cicatrix (scar) with notable scar tissue and hyperesthesia at proximal aspect of 
medial malleolus front/tarsal canal. The area is exquisitely sensitive to touch bilaterally. No 
range-of-motion loss in the ankle joint or subtalar joint is noted. There is an antalgic gait and 
the patient supinates in a static stance position.” The examiner stated “Currently the patient 
works as a manufacturing operator. He is able to do his civilian job.” Diagnosis was “Bilateral, 
chronic recurrent heel pain. Severity - severe.” Profile restriction was no running, jumping, 
marching or long-standing over 2 minutes. No Army Physical Fitness Test (APFT); footgear of 
comfort (no military footgear). There was no VA Compensation and Pension (C&P) exam 
performed. 

 

The Board directs attention to its rating recommendation based on the above evidence. The VA 
did not service-connect the CI’s foot conditions in either their initial VARD withour access to the 
STRs, or in remote post-separation VARD after service treatment records were provided. The 
PEB rated each foot at 10% coded 8799-8725 for moderate neuralgia of the posterior tibial 
nerve. IAW VASRD §4.124 (neuralgia, cranial or peripheral) moderate is the highest rating 
possible. The tarsal tunnel is correctly coded under the posterior tibial nerve, and there was 
insufficient evidence that the next higher nerve (internal popliteal nerve [tibial]) was materially 
involved. The Board considered if neuritis (IAW VASRD §4.123) was more appropriate than 
neuralgia; however, there were no organic changes and rating maximum would still be that for 
moderate (10%) and coding change would offer no benefit. There was no documented ankle 
joint pathology and no route to dual coding either foot given the provisions of VASRD §4.14 
(avoidance of pyramiding). The Board considered if the CI’s underlying pathology and surgeries 
for the disability of the right foot (plantar fascia release and two tarsal tunnel releases) would 
rate higher than the moderate (10%) under code 5284 (Foot injuries, other). The Board 
deliberated on the 20% criteria of “Moderately severe” combinding the nerve condition as 


neuritis and the plantar fascia surgery residuals under analogous coding of 8625-5284 IAW 
VASRD 4.71a. 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 adjudications for the bilateral foot pain condition as 10% for each foot. The 
Board concluded therefore that this condition could not be recommended for additional 
disability rating. 

 

 

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 pain condition and IAW VASRD §4.124a, the 
Board unanimously recommends no change in the PEB’s adjudications as 10% for each foot. 
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 

Left 

8799-8725 

10% 

Right 

8799-8725 

10% 

COMBINED (w/ BLF) 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120609, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 XXXXXXXXXXXXXXXXXXX, 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 XXXXXXXXXXXXXXXX, AR20130005529 (PD201200737) 

 

 

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 XXXXXXXXXXXXXXXXX 

 Deputy Assistant Secretary 

 (Army Review Boards)