RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00477
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050208

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Unit Supply Specialist, medically separated for “bilateral lower extremity (tibial) periostitis…,” with a disability rating of 0%.

CI CONTENTION:  The CI indicates the bilateral leg conditions continue to impact her life, limiting her ability to stand, sit, and walk.  She also indicates her right knee gives out. The CI’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 based on 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 - 20041116	VARD - 20051215	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Lower Extremity (Tibial) Periostitis…	5022	0%	Shin Splint, Right Leg	5299-5262	0%	STR	
			Shin Splint, Left Leg	5299-5262	0%		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Bilateral Lower Extremity (Tibial) Periostitis.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s shin splint condition began in 2001 after running.  The first record in evidence is an evaluation in physical therapy (PT) dated 11 September 2002 which noted right greater than left shin splints for the past year which were aggravated by running.  She was placed on duty limitations and began PT.  A bone scan in September 2003 (report not in evidence) showed bilateral stress reactions.  Despite treatment, her symptoms persisted.  An X-ray of the right leg was normal on 30 March 2004 and X-rays of both legs were normal on 3 May 2004.  A bone scan on 18 May 2004 was suggestive of bilateral shin splints.   The MEB forwarded “bilateral shin splints unresponsive to treatment” for PEB adjudication.  

The MEB NARSUM examination was dated 25 August 2004, 5 months prior to separation.  The CI reported ongoing pain aggravated by activity, right greater than left.  She was unable to run.  On examination, she was moderately tender bilaterally from 2 inches below the knees to 2 inches above the ankles over the tibiae (shins).  The examination of her lower extremities was otherwise unremarkable.  

The CI did not report for the VA Compensation and Pension (C&P) evaluation scheduled for 21 October 2005.  No other C&P examination was in evidence.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral shin splint condition 10%, coded 5022 (periostitis), noting that there was no limitation in motion.  The VA separately rated the shin splint condition 0% each, coded 5299-5262 (analogous to impairment of the tibia and fibula), citing the service treatment records and noting that the CI had not reported for the scheduled CA &P examination.  The Board considered the evidence.  The code 5022 supports a 10% for involvement of two or more major joints without incapacitation.  The code 5262 supports a 10% rating for slight knee or ankle disability; neither was recorded to support use of this rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommended a disability rating of 10% for the bilateral shin splint condition, coded 5022.  

BOARD FINDINGS:  In the matter of the bilateral shin splint condition, the Board unanimously recommends a disability rating of 10%, coded 5022 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Bilateral Lower Extremity (Tibial) Periostitis	5022	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150531, 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, AR20170000143 (PD201500477)

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 10% 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
(  ) DVA