RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04030
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050607

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E-6, Patriot Fire Control Operator, medically separated Informal Physical Evaluation Board (IPEB) for “bilateral lower extremity [BLE] exertional compartment syndrome” with a disability rating of 0%.

CI CONTENTION:  The CI requested all conditions be evaluated.  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 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 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 - 20050412	VARD - 20050711	
Condition	Code	Rating	Condition	Code	Rating	Exam	
BLE Exertional Compartment Syndrome	5399-5312	0%	Left Leg Compartment …	5399-5312	10%	20050509	
			Right Leg Compartment…	5399-5312	10%	20050509	
RATING:  0%	COMBINED RATING:  60%	

ANALYSIS SUMMARY:

BLE Condition.  The CI was first noted in the record to have a fascial (fibrous lining over the muscles) defect in July 2004 with an attendant compartment syndrome (pain and possible muscle damage due to swelling of the compartment with a loss of blood flow).  His symptoms were worse on the left and this side was treated with a fascial release (fasciotomy) on the left on 23 July 2004, with improvement in symptoms, and the right on 24 September 2004.  Although his symptoms were decreased, he was still unable to meet full duty requirements and was referred for an MEB.  The MEB narrative summary (NARSUM) was dated 21 March 2005, 2 months prior to separation.  The CI reported that he could not walk briskly, run, or jump.  On examination, the scars were well healed, but tender to deep palpation.  Some superficial sensory changes were present near the incision sites.  He was also noted to have eczema, an unrelated condition.  Otherwise, the examination was normal and range-of-motion (ROM) of the ankles was full.

At the VA Compensation and Pension (C&P) exam performed on 9 May 2005, 1 month before separation, the CI reported BLE pain since running in 1993.  His pain increased with walking more than two to three blocks and climbing up or down stairs.  His gait was abnormal, but this was attributed to knee pain.  The scars were noted to be well healed, but tender.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB and VA both coded the leg condition as 5399-5312 (analogous to muscle group XII impairment), but at 0% combined and 10% each, respectively.  The gait was abnormal, but this was attributed to the knee condition (not in scope).  However, the CI reported limitations in walking to two to three blocks and ascending/descending stairs.  The Board considered this and noted that the knee condition also contributed to these limitations which were thought to be at the moderate level.  Reasonable doubt was resolved in favor of the CI.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the BLE exertional compartment syndrome retaining code 5399-5312.

BOARD FINDINGS:  In the matter of the BLE exertional compartment syndrome, the Board unanimously recommends a disability rating of 10%, each, coded 5399-5312, IAW VASRD §4.73.  There were no other conditions within the Board’s scope of review for consideration.  The Board, therefore, recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation:

CONDITION	VASRD CODE	RATING	
Left Lower Extremity Exertional Compartment Syndrome	5399-5312	10%	
Right Lower Extremity Exertional Compartment Syndrome	5399-5312	10%	
RATING (w/BLF)	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 AR20160005172  (PD201404030)

1.	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, accept the Board's recommendation to modify the individual's disability rating to 20% without re-characterization of the individual's separation.  This decision is final.

2.	I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.

3.	I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

  BY ORDER OF THE SECRETARY OF THE ARMY:

CF:
(  ) DoD PDBR
( ) OVA