RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01118
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070822

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Automated Logistical Specialist, medically separated for “costochondritis,” with a disability rating of 0%.

CI CONTENTION:  “Review all documents, I would like all MEB/PEB conditions considered for being unfit for duty and rated.”  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 - 20070628	VARD – N/A	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Costochondritis	5099-5003	0%	No VA examination in evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  n/a	

ANALYSIS SUMMARY:  

Costochondritis:    According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s chest pain condition began in March 2005 after physical training.  The MEB forwarded “left upper costochondritis [inflammation of the costal cartilage, the structure that connects each rib to the sternum at the costosternal joint ] with chest pain” for PEB adjudication.  The MEB NARSUM examination on 8 June 2007, 3 months prior to separation, noted complaints of a constant, achy pain that increased in intensity with increased activities and lifting the CI’s left arm.  The physical examination revealed “…the first, second, and third ribs at the sternal joint area show pain on palpation increasing towards the shoulder area.  It is a very tender and excruciating pain at the midline of the first and second ribs.”  

The CI did not request a VA Compensation and Pension (C&P) evaluation.
The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the costochondritis condition 0%, analogously coded 5099-5003 (arthritis, degenerative), citing the US Army Physical Disability Agency pain policy, rated as minimal/constant.  The Board noted that the 5321 code (Muscles of respiration: Thoracic muscle group) was most appropriate for the anatomic location of the pain.  IAW VASRD §4.40 (functional loss) the CI’s subjective reporting of pain with use and objective finding of tenderness and excruciating pain on palpation at the first and second ribs met criteria for a 10% rating.  The Board also deliberated if the CI’s disability met the maximum “severe or moderately severe” rating criteria at 20%.  The Board determined the evidence did not support the 20% rating criteria because the chest wall pain did not prevent her from accomplishing her normal activities of daily living and respiratory function.  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 costochondritis condition, coded analogously to 5399-5321.  

BOARD FINDINGS:  In the matter of the costochondritis condition, the Board unanimously recommends a disability rating of 10%, coded 5399-5321 IAW VASRD §4.59a.  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	
Costochondritis	5399-5321	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150604, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB										

MEMORANDUM FOR Commander

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXXX, AR20170002608 (PD201501118)

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