RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03176
BRANCH OF SERVICE:  Army  	separation DATE:  20090924

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-2, (Calvary Scout), medically separated for “bilateral tibial stress syndrome” rated at 20%.

CI CONTENTION:  “Please consider all conditions.”  The applicant mentioned constant pain in his legs and loss of use of his creative organ.  His complete submission is at Exhibit A.    

SSCOPE 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 based upon a 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 20090924	VARD - 20091217	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Tibial Stress Fracture/Shin Splints	5299-5262	10%	Shin Splints Left; Stress Fracture to the Left Tibial Plateau	5262-5311	10%	2001029	
Right Shin Splints	5299-5262	10%	Shin Splints, Right 	5311	10%	2001029	
Urethral Stricture	Not Unfitting	Postoperative Residuals, Urethral Stricture	7518	10%	2001027	
		Erectile Dysfunction associated with Postoperative Residuals, Urethral Stricture	7599-7522	0%	2001027	
		Scar associated with Postoperative Residuals, Urethral Stricture	7599-7804	0%	2001027	
RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Bilateral Tibial Stress Syndrome Condition.   According to the service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral leg condition began in March 2009 after a road march during basic training.  A bone scan performed on 10 March 2009 demonstrated the left leg and foot stress fractures.  At the MEB NARSUM examination dated July 2009, 2 months prior to separation, the CI reported 6-7/10 pain in both legs which was aggravated by walking greater than one block.  He denied swelling.  Physical examination showed bilateral tibial (shin) tenderness to palpation.  Knee flexion was limited to 130 degrees bilaterally.  There was no swelling or ligamentous instability.  At the VA Compensation and Pension (C&P) examinations in October 2009, 1 month after separation, the CI reported pain in both knees and shins with running and prolonged standing.  Physical examination showed normal gait and muscle strength.  There was no left knee tenderness to palpation, limitation of motion, or instability.  There was no additional limitation of motion bilaterally with repetitive motion. There was tenderness with deep palpation over the tibia bilaterally.

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating for each lower extremity under an analogous 5262 code (tibia and fibula, impairment of), citing functional loss due to leg pain.  The VA also assigned a 10% rating for each leg using the 5262-5311 code (tibia and fibula, impairment of-Group XI muscle injury) for the left leg and 5311 (Group XI muscle injury) code for the right, citing moderate muscle disability.  Board members agreed that there was no evidence of moderate knee disability to support a 20% rating under the 5262 code (tibia and fibula, impairment of) or 5311 moderately severe muscle disability for either extremity.  Considering the totality of the evidence and mindful of VASRD §4.3 (reasonable doubt), Board consensus was that a combined disability rating of 20% for the bilateral shin splint condition was appropriately recommended in this case.

Contended PEB Conditions.  The Board’s main charge is to assess the fairness of the PEB’s determination that urethral stricture was not unfitting.  The urethral stricture condition was not profiled or implicated in the commander’s statement and were not judged to fail retention standards.  All were reviewed and considered by the Board.   There was no performance based evidence from the record that the urethral stricture condition significantly interfered with satisfactory duty performance.  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 contended urethral stricture condition and so no additional disability rating is recommended.

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.  In the matter of the contended urethral stricture condition, the Board unanimously recommends no change from the PEB determination as not unfitting.  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 2014-03176, 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), 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20160017164 (PD201403176)

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