RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200900 SEPARATION DATE: 20020312 

BOARD DATE: 20130208 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4, (92A10/Automated Supply and Logistics 
Specialist), medically separated for chronic bilateral plantar fasciitis. The CI developed pain in 
both feet when she was doing sprints during physical training. Despite extensive physical 
therapy (PT), podiatry consults, orthopedics consults, custom orthotics and steroidal injections, 
the CI failed to meet the physical requirements of her Military Occupational Specialty (MOS) or 
satisfy physical fitness standards. She was issued a permanent L3 Profile and referred for a 
Medical Evaluation Board (MEB). The MEB forwarded chronic bilateral plantar fasciitis on DA 
Form 3947 to the Physical Evaluation Board (PEB). The MEB forwarded no other conditions for 
PEB adjudication. The PEB adjudicated the chronic bilateral plantar fasciitis as unfitting, rated 
0%, with likely application of the US Army Physical Disability Agency (USAPDA) pain policy. The 
CI made no appeals, and was medically separated with a 0% disability rating. 

 

 

CI CONTENTION: “My ankle condition is more severe than previous accounted for because I 
have decrease in my range of motion and I can neither walk nor stand or sit for any prolonged 
period of time. The same with my lower back and knees.” The CI attached a 3-page statement 
to her application (contending related lower back pain, hip and knee pain, anxiety and 
depression) which was reviewed by the Board and considered in its recommendations. 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44, Enclosure 3, paragraph 5.e. (2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings 
for unfitting conditions will be reviewed in all cases. The unfitting bilateral plantar fasciitis 
condition will be considered by the Board as this condition meets the criteria prescribed in DoDI 
6040.44. The ankle condition will be considered by the Board as it relates to the unfitting 
bilateral plantar fasciitis condition. The other requested conditions (lower back pain, hip and 
knee pain, anxiety and depression) are not within the Board’s purview. 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. 

 


RATING COMPARISON: 

 

Service FPEB – Dated 20011218 

VA (*18 Mos. Post-Separation) – All Effective Date 20020313 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Bilateral Plantar 
Fasciitis 

5399-5310 

0% 

Bilateral Plantar Fasciitis 

5299-5278 

10% 

20030918 

Left Calcaneal Heel Spur 

5299-5271 

10% 

20030918 

Right Calcaneal Heel Spur 

5299-5271 

10% 

20030918 

.No Additional MEB/PEB Entries. 

Lumbosacral Sprain/Strain 

5237 

20% 

20030918 

Hypertension 

7101 

10% 

20030918 

L & R knee conditions 

4x 10% 

20050211 

Urinary Incontinence 

7599-7512 

60% 

20050211 

0% X 4 / Not Service-Connected x 7 

 

Combined: 0% 

Combined: 90%* 



* All claims denied (NSC) in original 20020701 VARD due to missed VA exams; DRO decision of 20040827 granted feet, back, 
and HTN ratings above (combined 50%); DRO decision of 20050316 added 4x knee ratings, Individual unemployability and 7512 
60% rating as above, all retroactive to 20020313. 

 

 

ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed in the CI’s application 
regarding the significant impairment with which her service-incurred condition continues to 
burden her. It is a fact, however, that the Disability Evaluation System (DES) has neither the 
role nor the authority to compensate members for anticipated future severity or potential 
complications of conditions resulting in medical separation. This role and authority is granted 
by Congress to the Department of Veterans Affairs (DVA). The Board utilizes DVA evidence 
proximal to separation in arriving at its recommendations; and, DoDI 6040.44 defines a 12-
month interval for special consideration to post-separation evidence. The Board’s authority as 
defined in DoDI 6044.40, however, resides in evaluating the fairness of DES fitness 
determinations and rating decisions for disability at the time of separation. Post-separation 
evidence therefore is probative only to the extent that it reasonably reflects the disability and 
fitness implications at the time of separation. 

 

Chronic Bilateral Plantar Fasciitis Condition (including associated Ankle limitations). 

 

The CI had a well-documented history of bilateral foot pain in the service treatment record 
(STR). X-rays of both feet indicated bilateral bone spurs (heels). Throughout the STR, there was 
documentation of exquisite tenderness to palpation (TTP) along the plantar arch, antalgic gait, 
with heel toe walking, almost no heel contact, bone spurs and plantar fascia tenderness. The CI 
was offered surgery multiple times, however she declined. In August 2001, a permanent L3 
profile was granted for chronic bilateral plantar fasciitis. 

 

The MEB examination, 5 months prior to separation, noted constant bilateral feet aching, and 
inability to tolerate 24 hour duty despite wearing special orthotic boots with soft padding, due 
to bone spurs and painful plantar fascia. The CI was advised to wear tennis shoes when off 
duty. Exam showed tenderness in the plantar fascia of both feet and also the sides of the heel 
and pain on movement of the under joints. There was no motor weakness or muscle atrophy. 
“She can't walk on her heels due to the pain and also on her toes with difficulty.” “Range of 
motion of both ankles done on 22 October 2001 showed right dorsiflexion lacks 20° (normal 0-
20°), plantar flexion 30° (normal 0-45°), inversion 0°, eversion 0°; left dorsiflexion lacks 20°, 
plantar flexion 30°, inversion 0°, eversion 0°. No active range of motion due to the pain and 
patient will not move feet.” Bilateral heel X-rays documented bilateral calcaneal spurring left 
greater than right. There was CT imaging for “Eval (of) symptomatic tarsal bony vs. fibrous 
coalition, with significant limitation of Range of Motion, R » L” with “a demonstrated fibrous 
coalition of the posterior facet of the subtalar joint best seen on image #9, on the right.” 

 

A podiatry exam 6 months prior to separation documented normal ROMs with the exception of 
lacking 10° of plantar flexion with contracture of the tendo-achilles soleus-gastroc R>L; bone 


spurs; increased bilateral heel pain with palpation on weight bearing and normal strength. The 
examiner recommended surgery. The assessment was “Plantar Fasciitis, Exostosis R calcaneous 
and Functional Equinus.” The commander’s statement also indicated a diagnosis of severe 
chronic plantar fasciitis spurs causing the CI to be placed on quarters several times due to 
swelling feet and intense pain. 

 

The VA Compensation & Pension (C&P) examination 18 months post separation documented 
ankle pain along with chronic bilateral tarsal and plantar pain due to bilateral plantar bone 
spurs and plantar fascia tenderness which was aggravated with standing and walking more than 
ten to fifteen minutes. The examiner stated: “There is only 10-15 degrees of plantar flexion in 
the bilateral ankles without any other passive or active range of motion due to guarding and 
pain. No other abnormal findings were noted.” 

 

The Board directs attention to its rating recommendations based on the above evidence. The 
PEB and the VA chose different coding options for the CI’s bilateral foot condition which 
materially impacted the level of disability rating. The PEB used the VA Schedule of Ratings per 
§4.73-4 Diagnostic Code 5310 Group X (muscle) Function: Movements of forefoot and toes; 
propulsion thrust in walking, and consolidated both feet into a single rating of 0% (Slight). The 
general application of the VASRD prescribes evaluations should be for single extremities unless 
otherwise specified in the code or condition for muscle injuries or nerve injury. If more than 
one extremity is evaluated separately, ratings are combined (under §4.25), using the bilateral 
factor (§4.26) where applicable. The VA considered the CI’s foot conditions as bilateral plantar 
fasciitis analogous to Code 5278 [Claw foot (pes cavus)], which includes a bilateral 
consideration within the 10% coding criteria; and also for left and right calcaneal heel spur 
analogous to 5271, ankle limited motion, at 10% for each foot IAW VASRD §4.71a. 

 

The STR noted that bilateral foot pain was caused by tender plantar fascia. The CI clearly met 
5310 criteria of Movements of forefoot and toes; propulsion thrust in walking as was evidenced 
by the MEB documentation that the CI would not move her feet due to pain, she had an 
inability to walk on heels or toes with tenderness in plantar fascia and sides of her heels, and 
pain on movement of the under joints. The CI required special orthotic boots with soft padding 
during duty hours and tennis shoes off duty. The Board deliberated over the level of the CI’s 
bilateral foot conditions and considered analogous coding options under 5099-5310 (Group X, 
IAW §4.73, Schedule of Ratings–Muscle Injuries), or under VASRD §4.71a—Schedule of ratings–
musculoskeletal system coding options of 5299-5271 (Ankle, limited motion), 5299-5278 (Claw 
foot [pes cavus] and/or 5299-5284 (Foot injuries, other), as well as §4.57, Static foot 
deformities. 

 

Given the CI’s underlying pathology and disability picture of foot pain with limited ankle 
dorsiflexion particularly on the right, the Board majority considered the disability picture was 
closest to that depicted by 5299-5278 for the bilateral condition at 30%. The Board also took 
into consideration the tenants of §4.7 (higher of two evaluations). Alternative rating of 20% 
unilateral for the right and 10% unilateral for the left was considered, but not predominate. 

 

After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable 
doubt), the Board majority recommends a disability rating of 30% (Moderate) for the chronic 
bilateral plantar fasciitis 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. As discussed above, PEB 
reliance on the USAPDA pain policy for rating chronic bilateral plantar fasciitis was likely 


operant in this case and the condition was adjudicated independently of that policy by the 
Board. In the matter of the chronic bilateral plantar fasciitis condition, the Board, by a vote of 
2:1, recommends a disability rating of 30%, coded 5099-5278 IAW VASRD §4.71a. The single 
voter for dissent (who recommended a disability rating of left foot coded 5999-5284 rated 10% 
and right foot coded 5999-5284 rated 10%) did not elect to submit a minority opinion. 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; and, that the discharge with severance pay be recharacterized to reflect permanent 
disability retirement, effective as of the date of her prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Chronic Bilateral Plantar Fasciitis (with Heel Spurs) 

5099-5278 

30% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120612, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 XXXXXXXXXXXXXX, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxx, AR20130006240 (PD201200900) 

 

 

1. Under the authority of Title 10, United States Code, section 1554(a), I approve the 
enclosed recommendation of the Department of Defense Physical Disability Board of 
Review (DoD PDBR) pertaining to the individual named in the subject line above to 
recharacterize the individual’s separation as a permanent disability retirement with the 
combined disability rating of 30% effective the date of the individual’s original medical 
separation for disability with severance pay. 

 

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: 

 

 a. Providing a correction to the individual’s separation document showing that 
the individual was separated by reason of permanent disability retirement effective the 
date of the original medical separation for disability with severance pay. 

 

 b. Providing orders showing that the individual was retired with permanent 
disability effective the date of the original medical separation for disability with 
severance pay. 

 

 c. Adjusting pay and allowances accordingly. Pay and allowance adjustment will 
account for recoupment of severance pay, and payment of permanent retired pay at 
30% effective the date of the original medical separation for disability with severance 
pay. 

 

 d. Affording the individual the opportunity to elect Survivor Benefit Plan (SBP) 
and medical TRICARE retiree options. 

 

 

 

 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)