RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03655
BRANCH OF SERVICE:  Army  	SEPARATION DATE:  20030827

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E2, Petroleum Supply Specialist, medically separated for “ bilateral lower leg pain,” with a disability rating of 0%.  

CI CONTENTION:  The CI elaborated no specific contention in her application.  

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 – 20030710	VARD - Based on Service Treatment Records (STR)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Lower Leg Pains…Consistent with Stress reactions	5099-5003	0%	Stress Fracture Right Tibia assoc. with Ankle and Knee Pain	5299-5262	0%	STR	
			Stress Fracture Left Tibia assoc. with Ankle and Knee Pain	5299-5262	0%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Bilateral Lower Leg Pain.  Absent a history of direct trauma, the CI developed bilateral lower leg pain, aggravated with running while in basic training.  Service treatment records (STR) indicated that plain X-rays were normal and bone scan revealed bilateral stress fractures of her lower legs.  Despite treatment to include medication, altered activities, and physical therapy, her painful symptoms remained with increased activity and or prolonged standing.  Her conservative treatment continued and she was referred to a Medical Evaluation Board (MEB).  Her limitations included no kneeling, crawling, or squatting and the commander’s statement corroborated such physical limitations.  At her MEB narrative summary (19 March 2003; 5 months prior to separation); she reported the correlation of bilateral leg symptoms with prolonged standing and impact activities.  Her physical examination was detailed and revealed bilateral tibia tenderness.  The knees had normal tracking without instability.  Ankle range of motion (ROM) was normal.  Repeat X-rays revealed normal tibias without evidence of increased bone thickening or periosteal reaction.  The bone mineral density was described as normal.  The examiner diagnosed bilateral tibial stress reaction.  The STR indicated that the CI “failed to report” for a General Medical Examination with the VA and hence there was no VA compensation filing that was accomplished at the time of this Board’s review.  Any impairment rating recommendation from this Board will be based upon the MEB examination and terminal encounter documents within the STR.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB chose to bundle the lower extremities and assign an analogous rating of 0% with the 5003 code (degenerative arthritis).  The Board first considered whether each leg condition remained separately unfitting, having decoupled them from the combined PEB adjudication.  Considering the CI’s totality of chronic symptoms coupled with normal knee and ankle findings and limited attendant disability, the Board reached the conclusion that it was the overall effect of both chronic tender tibias as being reasonably justified as unfitting.  After due deliberation in consideration of the totality of the evidence, the Board concluded that there was no VASRD basis for recommending a higher rating than the 0% conferred by the PEB.  

BOARD FINDINGS:  In the matter of the bilateral lower leg 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 20140725, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR Commander

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXXXXXXXXXX AR20160008702 (PD201403655)

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