RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-00439
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070625

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Medical Logistics Specialist, medically separated for “bilateral shin pain and discomfort,” with a disability rating of 0%.  

CI CONTENTION:  The applicant was not given a fair rating for her unfit condition.  The applicant’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (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 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 PEB - 20070504	VARD - 20070912	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Shin Pain...	5022	0%	Shin Splints Right Leg	5099-5022	0%	20070723	
			Shin Splints Left Leg	5099-5022	0%		
COMBINED RATING:  0%	COMBIEND RATING OF ALL VA CONDITIONS:  80%	

ANALYSIS SUMMARY:  

Bilateral Shin Pain.  The record showed that the CI was in the US Army Reserves from 2002 to 2004 and then reenlisted in the active Army and was accessed on 17 February 2006.  On 1 March 2006, 2 weeks later, she reported a 1-1/2 week history of leg pain while walking or running without a specific injury.  Her examination was remarkable for tenderness over the tibial shafts (shin bones).  X-rays were normal.  She was treated with medications, crutches, and duty limitations, but her pain persisted.  A bone scan on 7 July 2006 showed stress changes without fracture.  She was referred to physical therapy (PT) for pool exercises.  Repeat X-rays on 2 August 2006 were normal.  Due to persistent left > right leg pain, she had electrodiagnostic testing of the left lower extremity on 30 August 2006; it was normal.  Repeat X-rays on 6 September 2006 were again normal.  A primary care note dated 26 September 2006 recorded that she was under evaluation for job reclassification (MOS Medical Review Board [MRB]), but had decided to pursue a Medical Evaluation Board (MEB).  In PT on 16 October 2006, the CI had a normal gait and could hop on each leg with minimal pain.  Her shins were no longer tender to palpation.  At the MEB examination on 23 January 2007, the CI was tender to palpation over the shins.  The narrative summary was dated 2 March 2007, 6 months prior to separation.  The CI reported the onset of bilateral shin pain while running hills.  Her pain decreased with a modification in her activity level, but still precluded meeting full duty requirements.  It was recorded that an magnetic resonance image (MRI) on 7 July 2006 showed left > right periosteal stress reactions.  The Board noted that the CI actually had a bone scan that day and found no other evidence of an MRI.  This is thought to be a typographical error and had no bearing on the rating recommendation.  On examination, she had a tender left shin, but a normal gait.  The examination was otherwise unremarkable.  At the VA Compensation and Pension examination performed on 23 July 2007, a month after separation, the CI reported bilateral shin pain aggravated by prolonged standing or walking.  She was able to accomplish all activities of daily living except gardening which was limited by knee pain.  Her gait was normal.  Tenderness was noted over the shins bilaterally.  X-rays were normal.  

The Board directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA rated the bilateral shin splint condition at 0%, coded 5022 (periostitis), although the VA rated each separately and used the code 5022 analogously.  The Board noted that the CI was not limited by the bilateral stress reactions at separation other than in prolonged standing or waling.  Her gait was normal as had been multiple X-rays.  The Bone scan showed stress changes which would be expected to resolve with the reduction in activity.  The Board considered the evidence and found no route to a rating higher than the 0% adjudicated by both the PEB and VA.  The Board determined that the shin splints could be considered separately unfitting, but noted that this provided no rating benefit to the CI.  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 bilateral shin splint condition.  

BOARD FINDINGS:  In the matter of the bilateral shin splint 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.  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 20140103, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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, AR20160006633 (PD201400439)

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:

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA