Search Decisions

Decision Text

AF | PDBR | CY2013 | PD-2013-01914
Original file (PD-2013-01914.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX    CASE: PD-2013-01914
BRANCH OF SERVICE: NAVY  BOARD DATE: 20150120
SEPARATION DATE: 20041105


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve OC/E-5 (Officer Candidate) medically separated for “delayed union left fifth metatarsal fracture.” The condition could not be adequately rehabilitated to meet the physical requirements of his Rating or satisfy physical fitness standards. He was placed on limited duty and referred for a Medical Evaluation Board (MEB). The left foot condition, characterized as “delayed union left 5th metatarsal fracture” was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E. No other conditions were submitted by the MEB. The informal PEB adjudicated “delayed union left fifth metatarsal fracture” as unfitting, rated 10%. The CI made no appeals and was medically separated.


CI CONTENTION: “I was awarded 10% disability from the Navy for a foot injury which was not expected to ever heal. The VA has given me 0%. The foot still has issues and I agree with the Navy’s award. VA should follow suit.”


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 when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting. Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records. Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate. The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) / VASRD standards to the unfitting medical condition at the time of separation. The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions. That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws. The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.


 RATING COMPARISON :

Service IPEB – Dated 20040923
 VA - based on Service Treatment Records (STR)
Condition
 Code Rating Condition Code Rating Exam
Delayed Union Left Fifth Metatarsal Fracture 5283 10% Delayed Union Left Fifth Metatarsal Fracture 5284 0% STR
Other x 0 (Not in Scope)
 Other x 0
Combined: 10%
 Combined: 0%
Derived from VA Rating Decision (VA RD ) dated 20060609 ( most proximate to date of separation [ DOS ] ).


ANALYSIS SUMMARY:

Delayed Union Left Fifth Metatarsal Fracture. The CI injured his left foot in July 2003 playing sports while completing his Bachelor’s degree in an active duty status. X-rays at the time demonstrated a fracture of the 5th metatarsal bone of the left foot (the long bone on the outside aspect of the mid-foot). The CI reinjured the foot playing sports in January 2004 and X-rays demonstrated the persistence of the fracture. According to STRs he experienced intermittent foot pain after January 2004. Following graduation, the CI reported to Officer Candidate School in July 2004 and experienced left foot pain with running and prolonged standing. X-rays demonstrated evidence of incomplete healing (new bone formation but with a persistent fracture line of 4 millimeters in length) consistent with non-union of the left 5th metatarsal bone. At the time of the MEB orthopedic narrative summary (NARSUM) examination on 24 August 2004, the left foot was normal in appearance without evidence of deformity. There was tenderness to palpation of the left 5th metatarsal. The gait was normal. There was no VA Compensation and Pension examination proximate to separation.

The Board directed attention to its rating recommendation based on the above evidence. The PEB rated the delayed union left 5th metatarsal fracture 10%. The VA rated the condition 0% citing absence of post-separation medical treatment, examinations or evidence of moderate symptoms to support a 10% rating. The Board noted there was partial non-union of the left fifth metatarsal fracture without deformity (malunion). The CI was unable to tolerate the vigorous physical training and running required for military training but at the time of the MEB NARSUM examination, the gait was normal indicating mild impairment. All Board members agreed the evidence did not support a rating higher than the 10% (moderate) adjudicated by the PEB. 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 delayed union left 5th metatarsal fracture 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 delayed union left 5th metatarsal fracture 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 re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20131003, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record









                 
XXXXXXXXXXXXXXX
President
DoD Physical Disability Board of Review





 MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS
 Subj:    PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATION
Ref:     (a) DoDI 6040.44
(b) CORB ltr dtd XX Jun 15

In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual's records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy' s Physical Evaluation Board:

-        XXXXXXXXXXXXXXXXXXXX, former USN
-        XXXXXXXXXXXXXXXXXXXX, former USN
-        XXXXXXXXXXXXXXXXXXXX , former USN
-        XXXXXXXXXXXXXXXXXXXX, former USN







XXXXXXXXXXXXXXXXXXXX
Assistant General Counsel (Manpower & Reserve Affairs)

Similar Decisions

  • AF | PDBR | CY2012 | PD2012 01849

    Original file (PD2012 01849.rtf) Auto-classification: Denied

    Ratings for unfitting conditions will be reviewed in all cases. The initial VA Rating Decision (VARD) was based on the service treatment records (STR).The Board directs attention to its rating recommendationbased on the above evidence.The PEB and the VA rated pain right fifth metatarsal area as 5299-5279 (metatarsalgia) at 10%. The Board considered coding as 5283 (malununion of a metatarsal) but X-rays near separation indicated the fifth metatarsal had healed well with good alignment;...

  • AF | PDBR | CY2014 | PD-2014-01674

    Original file (PD-2014-01674.rtf) Auto-classification: Denied

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. A bilateral foot X-ray showed a healing left 2nd metatarsal stress fracture and a probable new stress fracture of the left 3rd metatarsal. I have carefully reviewed the evidence of record and the recommendation of the Board.

  • AF | PDBR | CY2013 | PD2013 00782

    Original file (PD2013 00782.rtf) Auto-classification: Approved

    Six weeks after the injury (18 June 2003), the orthopedic examiner noted the CI was without complaint and the left knee ROM was normal with flexion 0-110 degrees.In November 2005, the CI returned with a 2-week history of left knee pain. Although the examiner noted an effusion on physical examination, the MRI definitively noted, “there is no joint effusion” with evidence of degenerative changes. The Board did not surmise from the record or PEB ruling in this case that any prerogatives...

  • AF | PDBR | CY2013 | PD-2013-01938

    Original file (PD-2013-01938.rtf) Auto-classification: Denied

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation. RATING COMPARISON : Service IPEB – Dated 20050208VA -Based on Service Treatment Records(STR)ConditionCodeRatingConditionCodeRatingExam Stress Fractures, Bilateral Navicular Bone5003-528310%Left Foot Navicular Bone Stress Fracture528410%STR5003-528310%Right Foot...

  • AF | PDBR | CY2013 | PD-2013-01437

    Original file (PD-2013-01437.rtf) Auto-classification: Denied

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation. Post-Separation) ConditionCodeRatingConditionCodeRatingExam Bilateral Metatarsalgia527910%Bilateral Metatarsalgia s/p Metatarsal Fractures527910%20040914Other Conditions x 0 (Not In Scope)Other x 0 RATING: 10%RATING: 10% *Derived from VA Rating Decision (VARD) dated...

  • AF | PDBR | CY2012 | PD 2012 01902

    Original file (PD 2012 01902.rtf) Auto-classification: Denied

    CI CONTENTION : “ a) Service connection for status post third metatarsal stress fracture only rated (10%); b )Service-connection for left olecranon bursitis was never rated by the Physical Evaluation Board, the VA rated this condition at 10%; c) Service-connection for lumbar strain was never rated by the Physical Evaluation Board, the VA rated this condition at 20%: d) Pay Grade E3 at the time of separation, Physical Evaluation Board pay grade rating for E 1; e) VA current service connected...

  • AF | PDBR | CY2012 | PD-2012-00939

    Original file (PD-2012-00939.txt) Auto-classification: Approved

    The PEB combined the two conditions and adjudicated them as bilateral tibial stress fractures and stress fracture of right first metatarsal, unfitting, rated 0% with application of the US Army Physical Disability Agency (USAPDA) pain policy. RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation: UNFITTING CONDITION VASRD CODE RATING Bilateral Tibial Stress Fractures 5099-5003 10% Stress...

  • AF | PDBR | CY2013 | PD-2013-01762

    Original file (PD-2013-01762.rtf) Auto-classification: Denied

    Normal ankle and foot exam. For the ankle condition, the VA applied code 5271 (limited motion of the ankle) and rated it 10% consistent with “moderate” based on “minimal functional impairment.”Since the NARSUM and C&P exams addressed both the foot and ankle conditions together, the Board first considered which exam was the most probative exam on which to base its rating recommendation. Physical Disability Board of Review

  • AF | PDBR | CY2009 | PD2009-00547

    Original file (PD2009-00547.docx) Auto-classification: Denied

    The Board considered this evaluation in determining the CI’s condition at the time of separation from service. While the VASRD code 5276 could be used analogously, it appears that the malunion of the metatarsal fractures with subsequent pain, arthritis, and painful motion of the right foot and ankle as well as the inability to perform or sustain prolonged or exertional activities are the conditions that limited the CI’s ability to perform the required duties of his rank and rating. The CI...

  • AF | PDBR | CY2014 | PD-2014-00728

    Original file (PD-2014-00728.rtf) Auto-classification: Denied

    SEPARATION DATE: 20031218 The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. XXXXXXXXXXXXXXX, AR20150010577 (PD201400728)I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings...