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AF | PDBR | CY2013 | PD-2013-02220
Original file (PD-2013-02220.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX    CASE: PD-2013-02220
BRANCH OF SERVICE: Army  BOARD DATE: 20150204
SEPARATION DATE: 20050811


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-6 (Cavalry Scout) medically separated for bilateral foot pain. The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty. He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). The “chronic foot pain status post bunionectomy for bilateral hallux valgus with bilateral first metatarsophalangeal joint arthritis” was the only condition forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. The Informal PEB adjudicated his feet as unfitting and rated each at 10% with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). The CI made no appeals and was medically separated.


CI CONTENTION: The CI elaborated no specific contention in his application.


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) 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 :

IPEB – Dated 20050509
 VA* - (~9 Months Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Left Foot Pain… 5280 10% Residuals of Left Bunionectomy 5280 10% 20060509
Right Foot Pain… 5280 10% Residuals of Right Bunionectomy 5280 10% 20060509
Other x 0 (Not In Scope)
 Other x 7
RATING: 20%
 RATING: 40%
* Derived from VA Rating Decision (VA RD ) dated 200 60908 (most proximate to date of separation ( DOS ) ) .




ANALYSIS SUMMARY:

Bilateral Foot Pain. The first record in evidence for the bilateral foot condition is a sick call noted dated 19 March 2002 in which the CI notes a 2-month history of right>left foot pain aggravated by footwear. He was diagnosed with bilateral, right>left, hallux valgus (bunions). X-rays were ordered, but the first in the record are dated 25 November 2002 and confirmed the diagnosis. His symptoms progressed and he was evaluated by podiatry on 14 April 2004. The CI noted that these had been present for 2 years since a 27-mile road march. Surgery had been deferred to allow deployment. At this visit, the left side was the more symptomatic. On 6 May 2004, the CI had a bunionectomy (correction of the hallux valgus) on the right followed by the same surgery on the left on 2 September 2004. His post-operative recovery was complicated by noncompliance with therapy and overuse resulting in delayed healing. At a 29 March 2005 primary care appointment, he was noted to have had pain for a year and recommended for MEB. At a 21 April 2005 primary care appointment, he reported that the pain had begun after a road wheel fell on his feet in 2002. Previously, trauma, other than overuse, had been denied. The narrative summary was dated 29 April 2005, just over 3 months prior to separation. He reported that while deployed to a combat theater in 2002, a wheel fell off of a truck onto both feet with bilateral pain and swelling since then. On examination, he was noted to have mild edema, painful motion, and tenderness at the surgical sites bilaterally, but there was no limitation in range-of-motion and the scars were well healed. X-rays showed mild degeneration. A retained screw was removed from the left foot on 4 August 2005.

At the VA Compensation and Pension examination performed on 9 May 2006, 9 months after separation, the CI reported a crush injury of his feet in 2003. He was working full-time as a truck driver and had missed work for 3 days the previous year secondary to his feet. He stated that he could stand for an hour, walk half a mile, and run 150 yards. On examination, he walked without a limp and used no assistive devices. He had orthotics in his shoes which were new and shoe no abnormal wear pattern. The scars were well healed and the ROM of the toes was full.

The Board directed its attention to its rating recommendation based on the above evidence. The PEB and VA both coded the bilateral foot condition as 5280, hallux valgus, and rated each at 10%. The Board found no code which better described the condition and noted that this is the highest rating for this coding option. After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the bilateral hallux valgus 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 bilateral hallux valgus 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 20131030, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record






XXXXXXXXXXXXXXX
President
DoD Physical Disability Board of Review
SAMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557


SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXX, AR20150010571 (PD 201302220)


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              XXXXXXXXXXXXXXX
                           Deputy Assistant Secretary of the Army
                           (Review Boards)
                                                     
CF:
( ) DoD PDBR
( ) DVA

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