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AF | PDBR | CY2013 | PD-2013-02729
Original file (PD-2013-02729.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX         CASE: PD-2013-02729
BRANCH OF SERVICE: Army  BOARD DATE: 20150123
SEPARATION DATE: 20060402


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-5 (Multiple Launch Rocket System Operations / Fire Direction Specialist) medically separated for bilateral feet condition. The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty but was authorized to perform an alternative physical fitness test. He was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB). “Chronic plantar fasciitis” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other condition was submitted by the MEB. The Informal PEB adjudicated “bilateral chronic plantar fasciitis” as unfitting, rated 10% with likely application of the VA Schedule for Rating Disabilities (VASRD). The CI made no appeals and was medically separated.


CI CONTENTION: “The condition of my feet is degenerative and non-operable and has a significant negative impact on activity level and quality of life. The condition of my back is also degenerative and limits activity level as well as frequently causing severe pain and detracting from quality of life.”


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 20051205
 VA* - (~12 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Bilateral…Plantar Fasciitis 5399-5310 10% Bilateral Plantar Fasciitis 5299-5279 10% 20070409
Other x 0 (Not In Scope)
 Other x 2
RATING: 10 %
 RATING: 20%
* Derived from VA Rating Decision (VA RD ) dated 200 70605 (most proximate to date of separation ( DOS ) ) .


ANALYSIS SUMMARY:

Bilateral Chronic Plantar Condition. The CI initially presented with an 8-day history of right foot pain on 13 August 2002. An X-ray showed a heel spur (bony growth) consistent with plantar fasciitis. He was treated with medications, a shoe insert, and duty modification. He apparently improved as he deployed. While deployed, his symptoms recurred and were bilateral. He was again treated conservatively, but was no longer able meet duty requirements outside of garrison and was referred to MEB. The narrative summary was dated 17 October 2005, 6 months prior to separation. The CI reported that the pain began on the right side in 2002, but progressed and was now bilateral and that he was no longer able to run. He was noted to have flexible flat feet only on weight bearing associated with pronation (an inward roll of the foot). The range-of-motion of the ankles was noted to be reduced. The CI was diagnosed with bilateral chronic plantar fasciitis and pes planus (flat foot). He was noted to still be able to perform his duties while in garrison, but not deploy to the field. At the VA Compensation and Pension examination performed 12 months after separation, the CI reported the onset of pain if he walked over one mile or stood more than 45 minutes. He had a normal gait without unusual wear of his shoes. The feet were tender along the plantar fascia. He did not use inserts, but modified his activity to control his pain. The condition did not affect his current occupation.

The Board directed attention to its rating recommendation based on the above evidence. The PEB and VA both rated the bilateral foot condition at 10%, but used, respectively analogous codes for trauma, 5310 (abnormality of the muscles of the forefoot) and 5279 (metatarsalgia [pain of the long bones of the feet]). The Board noted that there is no specific code for plantar fasciitis. It also considered analogous codes for 5020 (synovitis) and 5276 (pes planus) but these provide no rating advantage to the CI. The Board noted that the code chosen by the PEB, 5310, actually refers to a muscle injury. The plantar fascia attaches the heel bone to the toes and is not a muscle itself. The Board considered that while the other codes discussed provide a better description, none provides a higher rating than the 10% adjudicated by the PEB. 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 plantar fasciitis 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 plantar fasciitis 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 20131217 w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record








                                   
XXXXXXXXXXXXXXXXXX
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 XXXXXXXXXXXXXXXXXX, AR20150008362 (PD201302729)


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

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