RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-00240
BRANCH OF SERVICE:  NAVY	BOARD DATE: 20150220
SEPARATION DATE:  20060803

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3 (Hospital Corpsman) medically separated for status post bilateral four compartment fasciotomy for exertional compartment syndrome.  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 status post bilateral four compartment fasciotomy for exertional compartment syndrome condition, characterized as “other disorder of muscle, ligament and fascia” was forwarded to the Physical Evaluation Board (PEB) SECNAVINST 1850.4E.  No other conditions were submitted by the MEB.  The Informal PEB adjudicated “status post bilateral four compartment fasciotomy for exertional compartment syndrome” as unfitting, rated 20%. The CI made no appeals and was medically separated.

CI CONTENTION:  “Their rating for the condition is too low because it has become a lifelong issue, resulting in additional medical problems.”

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:

Service IPEB – Dated 20060629	VA - (2 Mos. Pre-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Status Post Bilateral Four Compartment Fasiotomy For Exertional Compartment Syndrome
Right and Left 	5399-5312	10%	Right Leg Compartment Syndrome Status Post Fasciotomy with Superficial Peroneal Nerve Neuritis	5399-5312	10%	20060606	
	5399-5312	10%	Left Leg Compartment Syndrome Status Post Fasciotomy	5399-5312	10%	20060606	
Other x 0 (Not in Scope)	Other x 2 (Not in Scope)		
Combined:  20% (with Bilateral Factor)	Combined:  50%	
Derived from VA Rating Decision (VARD) dated 20060919 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:  

Status Post Bilateral Four Compartment Fasciotomy For Exertional Compartment Syndrome Condition.  The CI developed pain in both lower legs with running.  Orthopedic evaluation determined the CI’s calf muscle compartments developed abnormally high pressures with activity and diagnosed bilateral exertional compartment syndrome of the lower legs.  The CI underwent surgery in May 2005 to release the rigid tissue enclosures of the muscle compartments (fasciotomy) and reduce the abnormal pressure with activity.  Following recovery from surgery, lower extremity strength, sensation, range-of-motion and gait were normal, however the CI reported persistent pain with running interfering with performance of full duties.  On 9 May 2006, the MEB narrative summary recorded persistent pain with running more than 1/4-mile and pain at end of day after long day on his feet.  At the VA Compensation and Pension (C&P) examination on 6 June 2006, 2 months prior to separation, the CI reported pain with activity.  On examination, his gait was even though slow.  The calves were equal in circumference (15 centimeters), soft, and there was tenderness to palpation.  The scars were well healed.  The VA neurology C&P examination on 31 May 2006, 2 months prior to separation, recorded normal gait, normal ability to walk in heels and toes, with normal strength, sensation and reflexes of all extremities.

The Board directed attention to its rating recommendation based on the above evidence.  Both the PEB and the VA rated each leg 10% using VASRD coded 5399-5312 (muscle Group XII, moderate).  Although strength was normal, there was decreased endurance supporting the 10% rating for moderate.  There was no evidence to support a higher rating and there were no objective neurological deficits or joint problems for consideration of ratings under other codes.  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 status post bilateral four compartment fasciotomy for exertional compartment syndrome 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 status post bilateral four compartment fasciotomy for exertional compartment syndrome 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 20131226, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 25 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:

- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN