Search Decisions

Decision Text

AF | PDBR | CY2013 | PD2013 00626
Original file (PD2013 00626.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:    CASE NUMBER: PD13 00 626
BRANCH OF SERVICE: Army   BOARD DATE: 2013 0 9 25
Separation Date: 20050731


SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (35N / Wire System Repair) medically separated for a right foot condition. The CI complained several times during service about pain in his right foot and was diagnosed with a painful bunion deformity that continued to worsen with time; this foot pain was also exacerbated by injuries. The right foot condition could not be adequately rehabilitated to meet the physical requirements of his M ilitary Occupational Specialty or physical fitness standards, so he was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). The right foot condition, characterized as “hallux abductovalgus of the right with bunion , ” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The CI wrote and submitted an appeal contesting the MEB designation of the hallux abductovalgus (HAV) condition as existing prior to service (EPTS) . The PEB adjudicated the right foot HAV condition as unfitting but indicated that the condition as EPTS . The CI did not concur and requested a formal hearing; Reconsideration PEB adjudicated “hallux abductovalgus, right foot with bunion” as EPTS but rated it 10% disabling (with likely application of the Veterans Affairs Schedule for Rating Disabilities [ VASRD ] ) due to service aggravation. The CI made no appeals and was medically separated.


CI CONTENTION : The CI attached a two page statement to his application which was reviewed by the Board and considered in its recommendations. The statement was understood to contend conditions for the right foot, left foot, neck, back, and shoulder pain, emotional stress, migraine headaches, and mental effects.


 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 unfitting right foot condition is addressed below; no additional conditions are within the DoDI 6040.44 defined purview of the Board. The contended left foot, neck, back, shoulder, emotional stress, migraine headaches, and any mental effects were not reflected by either the MEB or PEB and are therefore not in scope. There is no evidence present for review that indicates the CI was n ever referred into the Disability Evaluation System (DES) with a mental health diagnosis. Additionally, there were no mental health entries in the entire s ervice treatment record (STR) present for review. 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.

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 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 Veteran s Affairs, operating under a different set of laws.
RATING COMPARISON :

Service Recon PEB – Dated 20050609
 VA - based on Service Treatment Records (STR)
Condition
 Code Rating Condition Code Rating Exam
Hallux Abductovalgus, Right Foot, with Bunion
 5280 10% Hallux Abductovalgus, Right Foot, with Bunion 5280 10% STR
No Additional MEB/PEB Entries
 Other x6 STR
Combined: 10%
 Combined: 10%
Derived from VA Rating Decision (VARD) dated 20051006 .
invalid font number 31502

ANALYSIS SUMMARY :
H allux Abductovalgus, Right Foot with Bunion Condition . In July 2001, a 35- pound dumbbell fell on the right great toe area , though an X- ray was negative for any fracture. The CI had a painful bunion deformity on the right foot which had been present for many years but became progressively m ore symptomatic . The condition was also exacerbated by running while on deployment in June 2003 . The CI was evaluated for a right bunion, aggravated with walking , with physical exam findings of mild swelling of the great toe. The examiner mad e a custom orthotic for the toe and diagnosed right hallux abductovalgus. The CI was followed by p odiatry for the bunion pain with physical findings of first metatarsophalangeal ( MTP ) joint pain with crepitus. Another examiner noted complaints of swelling and pain with limited ROM. In a follow-up appointment the p odiatrist indicated no improvement with a rigid toe shank orthotic and continued pain with motion . The c ommander’s s tatement noted that the CI’s injuries prevented him from being utilized effectively in his unit. The CI was given a permanent L3 p rofile for right foot HAV with bunion with additional restrictions of soft shoe wear permitted; Physical therapy may be supplemented at gym and pool; no running, no marching and no jumping. The MEB n arrative summary exam , accomplished approximately 8 months prior to separation , documented that the CI had symptoms of dull to sharp aching pain in the dorsal and medial prominences of the first MTP of the right foot. The CI failed treatments of orthotic inserts, shoe and activity modifications, padding, prof iles and pain medication , though he would take non-ste roidal anti-inflammatory drugs on an as needed basis. There were physical exam findings of tenderness to palpation over the dorsomedial eminence of right first MTP joint; hypertrophy of dorsomedial eminence of the first MTP joint; modest discomfort of ses a moid apparatus on palpation; an ability to dorsiflex beyond neutral with knees extended; first MTP joint range of motion was 65 degrees of dorsiflexion (normal 50 degrees) ; and mild dry cracking skin plantar aspect of hallux right foot indicative of modest dermatophytosis. There was no VA Compensation and Pension exam performed.

The Board directs attenti on to its rating recommendation based on the above evidence . The Recon sideration PEB coded the r ight f oot h allux a bductovalgus with b union condition as 5280 , unilateral h allux v algus, and ra ted i t 10% specifically citing, “There is sufficient evidence to support a finding that the current impairment EPTS, was subsequently aggravated by such service, and rendered the Soldier unfit. ” The VA coded and rated the condition the same based on the STR . Additionally, s ix subsequent VARDs continued the rating for this condition at 10%. There was no deduction made by the Recon sideration PEB for the EPTS condition. A s the CI was asymptomatic prior to military service , no deduction from the disability rating recommendation at separation is required. The VASRD unequivocally rates unilateral h allux v algus under code 5280 at 10% disabling , if either sever e or after operative resection of the metatarsal head (which did not occur in this case). There is no VASRD §4.71a route to a rating higher than 10% under any applicable code. 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 h allux a bductovalgus, r ight f oot with b union 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 h allux a bductovalgus, r ight f oot, with b union 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
Right Foot, Hallux Abductovalgus with Bunion
5280 1 0%
COMBINED
 1 0%


The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20 130512 , w/atchs
Exhib it B. Service Treatment Record
Exhibit C. Department of Veterans ’ Affairs Treatment Record



Physical 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 AR20130018781 (PD201300626)


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

Similar Decisions

  • AF | PDBR | CY2014 | PD-2014-02205

    Original file (PD-2014-02205.rtf) Auto-classification: Denied

    The CI was profiled and permitted to take the Army physical fitness test, alternate aerobic portion.He was issued a permanent L3 profileand referred for a Medical Evaluation Board (MEB).The skin condition (hypertrophic scar)was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.The MEB also forwarded four other conditions (see rating comparison chart below), all judged to meet retention standards.The Informal PEB found the hypertrophic scar on the left foot unfitting and rated it...

  • AF | PDBR | CY2012 | PD2012-00036

    Original file (PD2012-00036.docx) Auto-classification: Approved

    SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (44B/Welder), medically separated for bilateral bunion pain status post surgical correction of the left and of the right foot (joint at base of big toe). The PEB combined the right foot bunion pain condition and left foot bunion pain condition as a single unfitting condition, coded analogously to 5280 and rated 0%. I direct that all the Department of...

  • AF | PDBR | CY2011 | PD2011-00984

    Original file (PD2011-00984.docx) Auto-classification: Denied

    The right hallux valgus/limitus condition (bunion surgery and post-surgical result) was the principle cause of the right foot pain surgery and chronic right foot pain and was considered in rating the CI’s primary unfitting foot pain condition. The VA exam summary for pes planus is discussed above and all symptoms from the pes planus condition were considered in the rating of the foot pain condition. In the matter of the contended pes planus and hallux valgus conditions, the Board...

  • AF | PDBR | CY2014 | PD-2014-00119

    Original file (PD-2014-00119.rtf) Auto-classification: Denied

    SEPARATION DATE: 20070304 The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of theVeterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. Post-Separation)ConditionCodeRatingConditionCodeRatingExam Right Foot Pain5299-528010%S/P Surgery Hallux Valgus Right Foot52800%20070510S/p Surgical Scar Hallux Valgus Right...

  • AF | PDBR | CY2012 | PD2012 00620

    Original file (PD2012 00620.rtf) Auto-classification: Approved

    The PEB adjudicated the bilateral foot pain and bilateral hallux valgusconditionsas a single unfitting condition, rated 10%, with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).The remaining conditions were determined to be not unfitting.The CI made no appeals and was medically separated. The VA rated the bilateral foot condition separately as hallux valgus, coded5280, at 10% for each foot for a combined rating of 20%. BOARD FINDINGS : IAW DoDI 6040.44,...

  • AF | PDBR | CY2013 | PD-2013-02003

    Original file (PD-2013-02003.rtf) Auto-classification: Denied

    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. 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...

  • AF | PDBR | CY2012 | PD-2012-01943

    Original file (PD-2012-01943.txt) Auto-classification: Approved

    RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW NAME: XXXXXXXXXXXXXXX CASE: PD1201943 BRANCH OF SERVICE: ARMY BOARD DATE: 20130313 SEPARATION DATE: 20030101 SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (68X/AH-64/Systems Repair) medically separated for a right foot condition. Any conditions or contention not requested in this application, or otherwise outside the Board’s defined scope of...

  • AF | PDBR | CY2013 | PD2013 00128

    Original file (PD2013 00128.rtf) Auto-classification: Approved

    The VA, in its rating decision of 7 October 2003, utilized code 5242, degenerative arthritis of the spine, as per the current VASRD rating guidelines in effect at that time.The VA rating decision dated 29 July 2003, 2 months proximate to the date of separation, rated the CI’s condition at 0%, based upon an examination that revealed neither painful nor limited motion. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a...

  • AF | PDBR | CY2014 | PD-2014-00357

    Original file (PD-2014-00357.rtf) Auto-classification: Approved

    The Board directed attention to its rating recommendationbased on the above evidence.Although not specified, it appeared that the PEB and VA combined both (surgical) feet as a single unfitting condition, coded as a peripheral nerve condition coded 8727 (neuralgia) and rated at 0%.The Board first agreed that there was sufficient evidence to support the unbundling of the feet based on the necessity for bilateral surgery and constant post-operative pain as well as abnormal sensation in each...

  • AF | PDBR | CY2012 | PD2012-00342

    Original file (PD2012-00342.pdf) Auto-classification: Denied

    (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 Board determined that only the left foot hammer toe condition is within its purview in this case. The single unfitting condition was the painful, persistent left hammer toe condition after surgical correction. Service Treatment Record Exhibit C....