RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201224 SEPARATION DATE: 20020829 

BOARD DATE: 20130306 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty PV2/E-2 (68S10/Preventive Medicine Specialist), 
medically separated for pain left foot with stress fractures of the second and third metatarsals 
and stress reaction of the left foot. The CI had a history of chronic left foot and ankle pain since 
early advanced infantry training (AIT). He denied a history of injury. The CI 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 MEB forwarded stress fracture of the third 
metartarsal, possibly the second metatarsal and stress reactions to left foot per bone scan 
conditions, identified in the rating chart below, as being medically unacceptable. The Physical 
Evaluation Board (PEB) adjudicated pain left foot with stress fractures of the second and third 
metatarsals and stress reaction left foot condition as unfitting rated 10%, with likely application 
of the Veterans Affairs Schedule for Rating Disabilities (VASRD). The PEB combined the two 
MEB conditions into one unfitting condition. The CI made no appeals and was medically 
separated with a 10% disability rating. 

 

 

CI CONTENTION: “Stress Fractures on Foot due to boots being to small & lose of hearing.” 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. Ratings for unfitting conditions will be reviewed 
in all cases. The rated, unfitting condition (pain left foot with stress fractures of the second and 
third metatarsals and stress reaction left foot) as requested for consideration meet the criteria 
prescribed in DoDI 6040.44 for Board purview. The other requested condition (loss of hearing) 
is 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 respective Board for Correction of Military Records. 

 

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 
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. That role and authority is granted by Congress to the Department of 
Veteran Affairs, operating under a different set of laws. Post-separation evidence is probative 
to the Board’s recommendations only to the extent that it reasonably reflects the disability at 
the time of separation. 

 

 

 


 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20020725 

VA - (~1 Mo. Post-Separation) 20020830 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Pain L Foot w/ Stress 

5279 

10% 

S/P L Third Metatarsal Fx… 

5279 

10%* 

20030521 

No Additional MEB/PEB Entries 

NSC x 5 

20030521 

Combined: 10% 

Combined: 10% 



VARD 20030712 (most proximate to Date of Separation) 

* Rating increased to 20% from 20020830 and VASRD Code changed to 5284. Overall combined rating was 30% when VA added 
Tinnitus at 10% from 20020830. No Second foot C&P exam in CPF. 

 

 

ANALYSIS SUMMARY: 

 

Pain Left Foot with Stress Fractures of the Second and Third Metatarsals and Stress Reaction 
Left Foot. The CI presented for left foot and ankle pain in early AIT without specific injury. X-
rays were negative and he was treated conservatively without resolution of his pain. A bone 
scan revealed stress reactions throughout the left foot and a healing stress fracture of the third 
metatarsal which was consistent with a recent X-ray. He was issued a L3 profile and referred to 
MEB. At the MEB examination 2 months prior to separation, the CI reported a 7 month history 
of pain and that he could not bear his full weight. He was using a brace at the examination. 
The narrative summary (NARSUM) was dictated 3 days later by an orthopedic surgeon. The CI 
reported that his pain prevented him from meeting the requirements of his MOS and noted 
that the CI requested separation. It was noted that he had healing stress fractures of the third 
and possible second metatarsal bones, but was without tenderness over the bones and had no 
soft tissue changes. At the VA Compensation and Pension (C&P) exam performed 9 months 
after separation, the CI reported continued pain of the left foot relieved with non-weight 
bearing. He used no assistive devices and took Ibuprofen for pain. He was working at a local 
store stocking shelves. On examination, his gait was mildly antalgic. No signs of muscle wasting 
were present. The foot was mildly tender over the second and third metatarsals. No swelling 
was present. He wore new shoes, so an assessment for abnormal wear was not possible. X-
rays of the left foot and ankle were done, but the results not annotated. He was diagnosed as 
status post (s/p) left third metatarsal fracture with persistent metatarsalgia (pain). 

 

The Board directs attention to its rating recommendation based on the above evidence. The VA 
and PEB both rated the left foot condition at 10% and coded it 5279, metatarsalgia. The Board 
noted that, as documented on the 21 November 2006 VA Rating Decision (VARD), the VA 
subsequently changed the coding to 5284, other foot injuries, and increased the rating to 20% 
retroactive to separation. However, neither the C&P nor the VARD specific to this increase 
were in the records available for review. The PEB combined the two MEB diagnoses into one 
unfitting condition. The primary symptom was pain with weight bearing. The Board 
determined that the two conditions could not be severed for rating purposes without violation 
VASRD §4.14, (Avoidance of pyramiding). The Board noted that the CI was employed stocking 
shelves after separation and that the stress fracture had healed the expected clinical course. 
The metatarsals were non-tender at the MEB examination and minimally so at the C&P almost 
a year later. No muscle loss was present and no assistive devices in use. The Board determined 
that the examinations proximate to separation do not support a moderately severe disability to 
justify a 20% rating under the code 5284 and that no other code provided a route to a higher 
rating adjudicated by the PEB and VA at the time of separation. After due deliberation, 


considering all of the evidence and mindful of VASRD §4.3 (Resolution of reasonable doubt), the 
Board concluded that there was insufficient cause to recommend a change in the PEB 
adjudication for the left foot 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 pain in the left 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 

Pain Left Foot with Stress Fractures of the Second and Third 
Metatarsals and Stress Reaction Left Foot 

5279 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120614, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxxx, AR20130008714 (PD201201224) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)