RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01097
BRANCH OF SERVICE:  NAVY	SEPARATION DATE:  20090401

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Fireman Machinist Mate Striker, medically separated for “left leg parosteal osteoma status post (S/P) excision” with a disability rating of 10%.  

CI CONTENTION:  Additional unfitting conditions were not considered.  The complete submission is at Exhibit A.

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(s) at the time of separation.  The panel 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 panel 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 - 20081201	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Leg Parosteal Osteoma S/P Excision	5099-5003	10%	No VA Examination Proximate to Separation in Evidence	
Left Knee Pain	Cat II		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:

Left Leg Parosteal Osteoma S/P Excision.  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI had a parosteal osteosarcoma (a bone cancer) of the left proximal tibia (shin bone near the knee) removed on 15 May 2008.  

The 6 October 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of residual pain.  Physical examination showed a stable left knee with neurovascular examination intact.  Tenderness was present over the scar with a positive sign for peroneal nerve irritation.  Left knee range of motion was extension of 0 degrees (normal) and flexion of 110 degrees (normal 140); painful motion and gait were not addressed.  There was no VA examination in evidence proximate to separation for the panel to review.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left leg condition 10%, analogously coded 5099-5003 (arthritis, degenerative).  The PEB also listed left knee pain as a related Category II condition (a condition that contributed to the primary unfitting condition but was not separately ratable).  The left knee limitation in motion was not compensable and painful motion was not documented.  The knee was stable.  There were no gait comments made implying it was normal or near normal.  There were no examination findings regarding the menisci which implied no pathology.  Pain at the surgical site was present and signs of peroneal nerve irritation was present.  The panel noted the pain at the surgical site could support a 10% rating under code 5262 (tibia and fibula, impairment) or code 8721 (neuralgia, common peroneal nerve); both rated at the slight impairment level which did not provide a rating advantage to the CI.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the left leg condition.

BOARD FINDINGS:  In the matter of the left leg condition and IAW VASRD §4.71a and §4.124a, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150608, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44

      In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN

		
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	     				                                Acting