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AF | PDBR | CY2012 | PD2012 01268
Original file (PD2012 01268.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:    CASE NUMBER: PD1201268
BRANCH OF SERVICE: Army  BOARD DATE: 20130426
Separation Date: 20030221


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (92G/Food Operations Specialist), medically separated for reflex sympathetic dystrophy (RSD) of the left foot. The CI developed atraumatic severe left foot pain in December 2001. Despite a comprehensive evaluation and extensive treatment by the pain specialty clinic, the CI failed 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 RSD in Left Foot to the Physical Evaluation Board (PEB). No other conditions were submitted by the MEB. The Informal PEB (IPEB) adjudicated the left forefoot pain with coolness of the forefoot/RSD as unfitting, rated 10%, with likely application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The CI made no appeals, and he was medically separated with a 10% disability rating.


CI CONTENTION: The application states, “I suffered a disabiting injury while run and got reflex sympathetic dystrophy. I still suffer major pain and lose ability to do many things. Now I work dead end jobs because I can’t stand for a long time. I just served my country in the USMCR and Army. I did all doctors asked me to do and only got worse. No cure is available and being a single father makes it hard on my daughter.”


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 left foot RSD is addressed below and no additional conditions are within the DoDI 6040.44 defined purview 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 Board for Correction of Military Records.


RATING COMPARISON :

Service IPEB – Dated 20021202
 VA - Service Treatment Record (STR) USED
Condition
 Code Rating Condition Code Rating Exam
Left Forefoot Pain 8799-8720 10% Regional Pain Syndrome, Left Foot 8799-8725 0% STR
No Additional MEB/PEB Entries
 Other x 0
Rating: 10%
 Rating: 0%


ANALYSIS SUMMARY: 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 Veterans 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.

The Board acknowledges that service treatment record (STR) notes were not available in the evidence before it and they could not be located after the appropriate inquiries. Several attempts at locating these records proved unsuccessful. Any further attempts at obtaining the relevant documentation would likely be futile and introduce additional delay in processing the case. The missing evidence will be referenced below in relevant context.

Left Foot RSD Condition. The Medical Examination Form 2808 noted chronic right foot pain. The commander’s statement indicated that the CI was unable to stand for longer than 15 minutes at a time without resting and he was unable to qualify on his assigned weapon, which all prevented the CI from performing within his MOS. The CI was given a permanent L3 Profile for RSD with chronic nerve pain in leg. The narrative summary (NARSUM) examination approximately 3 months prior to separation documented that the CI had severe, persistent, and disabling pain in the left forefoot after an atraumatic onset of symptoms in December 2001. The physical exam findings were diffuse left forefoot tenderness with slight coolness to touch. Pulses were strong in both feet. A bone scan and X-rays were both normal. The CI underwent multiple modes of treatment; however, he had complaints of pain with simple walking and standing. The examiner opined that no significant improvement in his condition was expected in the near future. A VA Compensation and Pension (C&P) examination was scheduled three times (in 2003, 2004, and 2010) and but the CI failed to show for all appointments.

The Board directs attention to its rating recommendation based on the above evidence. The PEB coded the left foot RSD condition analogous to 8720 sciatic nerve neuralgia and rated 10% (mild). The VA coded the regional pain syndrome, left foot analogous to 8725 posterior tibial nerve neuralgia rated 0% based on the STR. The CI failed to show for two scheduled C&P examinations. The Board considered the tenants of §4.124 neuralgia, cranial or peripheral characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the same scale, with a maximum equal to moderate incomplete paralysis. The Board made note of the numerous records that were missing and unavailable to assist with deliberation. 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 for the left foot RSD 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 left fore foot pain condition and IAW VASRD §4.124a, 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
Left Forefoot Pain 8799-8720 10%
RATING
 10%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20120611, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record




P hysical Disability Board of Review


SFMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD-ZB),

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130010240 (PD201201268)


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                                                 
                                                      (Army Review Boards)

CF:
( ) DoD PDBR
( ) DVA

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