IN THE CASE OF

		BOARD DATE:	    14 August 2014

		DOCKET NUMBER:  AR20140001034 


THE BOARD CONSIDERED THE FOLLOWING EVIDENCE:

1.  Application for correction of military records (with supporting documents provided, if any).

2.  Military Personnel Records and advisory opinions (if any).


THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE:

1.  The applicant requests the DD Form 214 (Certificate of Release or Discharge from Active Duty) of her deceased husband, a former service member (FSM), be corrected to show in item 28 (Narrative Reason for Separation) the entry "Service-connected, received service-connected at 50-percent rating" vice "Disability, Existed Prior to Service, Physical Evaluation Board (PEB)." 

2.  The applicant states she knows the FSM did not have any injuries to his feet before entering the Army.  She has copies of his medical records that state the injury did not exist prior to service, along with letters he wrote to her while in service that told her about him injuring his foot while in boot camp. 

3.  The applicant provides: 

* DD Form 214
* Certificate of Death
* Hospital admission report
* Page 1 of his DD Form 2807 (Report of Medical History)
* Page 1 of his DA Form 3947 (Medical Evaluation Board (MEB) Proceedings) 

CONSIDERATION OF EVIDENCE:

1.  The FSM enlisted in the U.S. Army Reserve under the Delayed Entry Program (DEP) on 22 February 2006.  In connection with his enlistment, he underwent an entrance physical at the Oklahoma City Military Entrance Processing Station. 
2.  His DD Form 2807-1 (Report of Medical History) listed several medical conditions related to his ear surgery and hearing loss, blood pressure, and issues with his testicles.  He was initially disqualified for service but he was ultimately accepted.

3.  He was discharged from the DEP on 1 March 2006 and enlisted in the Regular Army on 2 March 2006.  He was assigned to Fort Jackson, SC, for completion of training.  

4.  On 29 June 2006, he underwent a physical examination that led to a diagnosis of plantar fasciitis, medically unacceptable in accordance with Army Regulation 40-501 (Standards of Medical Fitness), chapter 3-41(e); Line of duty: Yes; Existed prior to service: No;  Service aggravated: Not applicable.  His narrative summary shows:

	a.  History of present illness:  The pain in the right foot started after a six-mile road march in early May 2006.  It started to hurt midway through then increased at the end.  He went to the medical clinic and was put on a profile for no high impact activities.  It came to a head when walking from the cafeteria, his foot felt like it was on fire and the pain increased to 10/10.  The pain has decreased minimally since it started.  

	b.  Past History:  He denies any medical conditions.  No allergies.  No alcohol. No tobacco use.  

	c.  Review of symptoms:  Right foot pain.

	d.  Physical examination:  General appearance; alert and oriented to time, place, and person; well nourished and well hydrated; healthy appearing. Cardiovascular system; arterial pulses equal bilaterally and normal at the dorsalis pedis and posterior tibial.  Edema is not present.  Neurovascular function is intact.  Skin texture and turgor was normal as well as color and pigmentation with no skin lesions.  Musculoskeletal system for the ankle: there was no swelling of the ankle, erythema or warmth.  There was no deformity of the ankle.  Ankle was normal.  There was no pain elicited by motion of the ankle.  Foot: Plantar flexion and dorsiflexion of both feet were observed.  There was tenderness on palpation of the plantar aspect of the right heel.  There was no swelling, no erythema, and no abnormal warmth of the foot.  No tenderness with palpation of the posterior aspect of the right heel.  There was no tenderness to the plantar aponeurosis and the medial longitudinal arch.  Plantar pain was elicited by motion.  There was no tenderness on palpation of the sesamoid bone.  The left foot showed no tenderness on palpation of the plantar or dorsal aspects.  No loss of protective sensation was demonstrated in his feet.  
	e.  Laboratory and X-ray data:  The 2 May [2006] foot films showed slight stress reaction in the calcaneus below the subtalar joint.  His 18 May [2006] bone scan showed no right foot or calcaneal lesions.  His 20 June [2006] foot films showed no evidence of fracture, dislocation, inflammatory changes or arthritis.

	f.  Present condition:  He is not able to walk on his right foot without pain.  He is currently wearing a posterior splint on the right foot being non-weight bearing. He is taking Tylenol #3 for pain.  He can do work while seated and that does not require time on his feet.  He has been on crutches being non-weight bearing since early May.  He has taken Motrin, Tylenol, Ultrarn, and Percocet, with Percocet taking the edge off but not getting rid of the pain completely.  He exercises the foot, stretching exercises, and has cortisone injections.  The foot has been casted and is currently in a posterior splint.  He has been to medical quarters and had convalescent leave for two weeks.

	g.  Recommendations:  The Soldier has received maximum benefit of conservative therapy.  Further diagnostic studies are not indicated.  No surgery is indicated at this time.  His condition is unlikely to improve while here at Basic Training with the passage of time.  He is unfit for retention under Army Regulation 40-501 (standards of Medical Fitness), chapter 3, paragraph 41(e), because of his foot symptoms. 

5.  On 28 June 2006, he was issued a permanent physical profile listing the medical condition (injury) of planter fasciitis. 

6.  On 10 July 2006, an MEB convened and after consideration of clinical records, laboratory findings, and physical examinations, the MEB determined the FSM had the medically unacceptable condition of plantar fasciitis.  The MEB recommended he be referred to a PEB.  The FSM agreed with the MEB's findings and recommendation and indicated he did not desire to continue on active duty.

7.  On 30 August 2006, an informal PEB convened and after a review of the objective medical evidence of record, the PEB found the FSM's medical and physical impairment prevented reasonable performance of the duties required by his grade and MOS and determined that he was physically unfit due to plantar fasciitis.  The PEB noted that:

	a.  He suffered from bilateral plantar fasciitis secondary to symptomatic pes cavus (i.e., a high arch, often caused by a neurologic disorder or other medical condition, or may represent an inherited structural abnormality) manifesting in basic training in May 2006 following a hike.  Pain described as constant which limits his ability to walk and run.  Physical examination revealed no gross abnormalities: tenderness to palpation of the plantar fasciitis on the right foot and normal range of motion of his ankles.  

	b.  He is being separated for a medical condition that existed prior to his entry into the service which has not been permanently aggravated by service (emphasis added).  He is unable to perform the duties of his MOS or the duties of a Soldier.  He cannot move 2 miles with a fighting load.  He cannot construct an individual fighting position, run or jump, perform impact activities, or carry a rucksack or a combat load.  

	c.  The PEB reviewed the medical evidence of record and concluded that there was sufficient evidence to substantiate an existed prior to service (EPTS) condition for which he was found unfit.  His condition had not been permanently aggravated by service and was the result of natural progression.  

	d.  EPTS conditions are not compensable under the Army Physical Disability Evaluation System (PDES).  The proper disposition is separation from the Army without entitlement to disability benefits.  The FSM was classified under the Veterans Affairs Schedule for Rating Disabilities (VASRD) codes 5299/5278, but was not given a rating.  

8.  Subsequent to receiving counseling on the findings and recommendations and on his legal rights, the FSM concurred with the PEB's findings and recommendation and waived his right to a formal hearing of his case.  The PEB president approved the findings and recommendations of the PEB.

9.  He was honorably discharged on 18 September 2006.  The DD Form 214 he was issued shows he was discharged under the provisions of paragraph 4-24b(4) of Army Regulation 635-40 (Physical Evaluation for Retention, Retirement, or Separation) by reason of disability, EPTS.  This form further shows he completed a total of 6 months and 17 days of creditable active military service.  Item 26 (Separation Code) shows the entry "JFM" and item 28 shows the entry "Disability, Existed Prior to Service, PEB."

10.  Army Regulation 635-40 establishes the Army PDES and sets forth policies, responsibilities, and procedures that apply in determining whether a Soldier is unfit because of physical disability to reasonably perform the duties of his or her office, grade, rank, or rating.  

11.  Chapter 4 of Army Regulation 635-40 provides for the separation of enlisted Soldiers found to be unfit by a PEB due to a condition which existed prior to service or occurred in the line of duty and not due to the Soldier's misconduct.  Paragraph 4-24b(4) provides for separation for physical disability without severance pay.

12.  Army Regulation 635-40 states, in pertinent part, that according to accepted medical principles, certain abnormalities and residual conditions exist that, when discovered, lead to the conclusion that they must have existed or have started before the individual entered the military service.  Examples are congenital malformations and hereditary conditions or similar conditions in which medical authorities are in such consistent and universal agreement as to their cause and time of origin that no additional confirmation is needed to support the conclusion that they existed prior to military service.  

13.  Army Regulation 635-5-1 (Separation Program Designator (SPD) Codes) states that the SPD codes are three-character alphabetic combinations which identify reasons for and types of separation from active duty.  The SPD code "JFM" is the correct code for Soldiers separating under Army Regulation 635-40, paragraph 4-24b (physical disability existing prior to entry on active duty established by PEB proceedings; not entitled to severance pay). 

DISCUSSION AND CONCLUSIONS:

1.  The FSM suffered from a medical condition, plantar fasciitis, that was determined to be secondary to pes cavus.  He underwent an MEB that referred him to a PEB.  The PEB reviewed the medical evidence of record and concluded that there was sufficient evidence to substantiate an EPTS condition for which he was found unfit at the time.  His condition had not been permanently aggravated by service and was the result of a natural progression. 

2.  According to accepted medical principles, certain abnormalities and residual conditions exist that, when discovered, lead to the conclusion that they must have existed or have started before the individual entered the military service.  Examples are congenital malformations and hereditary conditions or similar conditions, such as pes cavus.  The PEB found him medically unfit and found compelling evidence to support a finding that he had an EPTS condition that was not permanently aggravated by military service.  Accordingly, the PEB recommended his separation by reason of physical disability without entitlement to severance pay.

3.  The Army does not use the term "service-connected disability."  This is a term used by the VA.  His narrative reason for separation was assigned based on the fact that he was separated under the provisions of paragraph 4-24b(4) due to his EPTS condition of plantar fasciitis.  The underlying reason for his MEB/PEB was his EPTS condition.  The only valid narrative reason for separation permitted under that paragraph is "disability, EPTS."  Therefore, the FSM received the proper narrative reason for separation.

4.  In view of the foregoing evidence, the applicant is not entitled to the requested relief.

BOARD VOTE:

________  ________  ________  GRANT FULL RELIEF 

________  ________  ________  GRANT PARTIAL RELIEF 

________  ________  ________  GRANT FORMAL HEARING

___X___  ___X____  ___X____  DENY APPLICATION

BOARD DETERMINATION/RECOMMENDATION:

The evidence presented does not demonstrate the existence of a probable error or injustice.  Therefore, the Board determined that the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned.



      __________X___________
       	   CHAIRPERSON
      
I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case.

ABCMR Record of Proceedings (cont)                                         AR20140001034



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ABCMR Record of Proceedings (cont)                                         AR20140001034



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