RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX CASE: PD1201817 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130315 

SEPARATION DATE: 20050114 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (92A/Automated Logistical Specialist), 
medically separated for a left foot condition. The CI began experiencing left foot pain in August 
of 2003 and was diagnosed with a hallux valgus deformity. The CI’s condition did not improve 
with conservative management and in June 2004 she underwent a bunionectomy. The CI could 
not be adequately rehabilitated to meet the physical requirements of her Military Occupational 
Specialty (MOS) or satisfy physical fitness standards. She was consequently issued a permanent 
L3 profile and referred for a Medical Evaluation Board (MEB). The left foot condition, 
characterized as “status post left foot bunionectomy with chronic pain,” was forwarded to the 
Physical Evaluation Board (PEB) as medically unacceptable IAW AR 40-501. No other conditions 
were submitted by the MEB. The PEB adjudicated the left foot condition as chronic pain, status 
post (s/p) left bunionectomy, unfitting, rated 10%. The CI made no appeals, and was medically 
separated with a 10% disability rating. 

 

 

CI CONTENTION: “At the time I was told that I would be limited to certain things in the Army if I 
stayed in. The doctors declared me medically unacceptable for the Army. I was placed on a 
permanent profile then put out the Army. Now I receive V.A. disability for my condition along 
with another issue. I told the doctor post surgery that I couldn't feel part of my big toe and I 
was told that there was the possibility that a nerve was damaged during surgery.” 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in 
Department of Defense Instruction (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 rating for the unfitting left foot condition is 
addressed below. Any conditions or contention intended for board review that may not have 
been requested in this application, or otherwise outside the Board’s defined scope of review, 
remain eligible for future consideration by the Army Board for the Correction of Military 
Records (ABCMR). In accordance with DoDI 6040.44, the Board’s authority is limited to making 
recommendations on correcting disability determinations. The Board’s role is thus confined to 
the review of medical records and all evidence at hand to assess the fairness of PEB rating 
determinations, compared to Veterans Administration Schedule for Rating Disabilities (VASRD) 
standards, based on ratable severity at the time of separation. The Board acknowledges the 
CI’s assertions that medical impropriety may have contributed to her disability disposition and 
that her military career was adversely impacted by her condition. It is noted for the record that 
the Board has no jurisdiction to investigate or render opinions in reference to such allegations; 
and, redress in excess of the Board’s scope of recommendations (as noted above) must be 
addressed by the ABCMR and/or the United States judiciary system. 

 

 

 

 

 


RATING COMPARISON: 

 

Service IPEB – Dated 20041020 

VA (2 Mos. Post-Separation) – Effective 20050115 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Pain s/p Left 
Bunionectomy 

5280 

10% 

Bunion, Left Foot, s/p Hallux 
Valgus Repair 

5280 

10% 

20050305 

.No Additional MEB/PEB Entries. 

Other X 4 

20050305 

Combined: 10% 

Combined: 60% 



VA rating from VARD 20050328 

 

 

ANALYSIS SUMMARY: 

 

Chronic Pain, Status Post Left Bunionectomy. The CI underwent an uncomplicated 
bunionectomy for a left hallux valgus deformity on 3 June 2004. Although serial post-operative 
radiologic studies showed normal post-surgical findings, the CI continued to experience 
persistent left foot pain and great toe numbness. She took narcotic medication for pain. At the 
narrative summary (NARSUM) exam in October 2004 (3 months prior to separation) she 
reported daily foot pain which was subjectively worse than before surgery. The left foot exam 
found mild to moderate tenderness to deep palpation of the dorsal medial surface. The range-
of-motion (ROM) of the first metacarpophalangeal joint (MTP; big toe joint) was decreased. 
Sharp sensation was absent and light touch sensation decreased on the medial aspect of the 
MTP joint. Gait was normal, although the CI walked with the left foot everted to avoid putting 
pressure on the great toe. At the VA Compensation and Pension (C&P) exam in March 2005 (2 
months post-separation) the CI reported that the deformity was gone, but the pain was worse 
than before surgery. The examiner noted 20 degrees of plantar/dorsal flexion of the 
interphalangeal joint. Pain occurred with any manipulation. Sensation of the dorsal aspect of 
the big toe was decreased. X-rays (March 2005) were normal except for surgical hardware and 
a mild deformity in the area of the first distal metatarsal bone. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB and VA both assigned a 10% rating, the maximum possible under the 5280 code (unilateral 
hallux valgus). The Board debated other rating pathways, but agreed that the evidence from 
the cited examinations did not justify the next higher 20% rating under the 5283 or 5284 codes 
(malunion of tarsal or metatarsal bones; other foot injuries). 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 of 
the chronic pain, s/p left bunionectomy 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 chronic pain, s/p left bunionectomy 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 

Chronic Pain, Status Post Left Bunionectomy 

5280 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294 dated 20121012 w/atchs. 

Exhibit B. Service Treatment Record. 

Exhibit C. Department of Veterans Affairs Treatment Record. 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxxxxxx, AR20130007492 (PD201201817) 

 

 

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)