RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2015-01354
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20071107

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Military Police, medically separated for “shin splints, bilateral, left greater than right,” with a disability rating of 20%.

CI CONTENTION:  “Rating originally 30%.”  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 - 20071005	VARD - 20080423	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Shin Splints, Left Greater than Right 	5399-5312	20%	Shin Splints, Right Lower Extremity	5299-5262	0%	20071215	
			Shin Splints, Left Lower Extremity				
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Bilateral Shin Splints.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was first evaluated for bilateral lower extremity pain in primary care on 4 August 2003.  She reported a 7 month history of pain aggravated by running.  She was thought to have bilateral ankle tendonitis and treated with medications, duty restrictions, and physical therapy.  She was seen periodically over the next 8 months for persistent pain.  A bone scan on 16 April 2004 was interpreted as probable early bilateral shin splints.  X-rays of the right leg the same day were normal.  The CI continued treatment and duty restrictions over the next few years.  On 17 April 2007, a repeat bone scan showed a probable stress fracture of the left shin bone (tibia).  She was seen in orthopedics on 21 June 2007 and noted to have persistent pain despite treatment.  On examination, the CI was tender over both shin bones.  X-rays were normal though.  The CI was then referred for MEB.  In physical therapy on 20 July 2007, the CI reported right > left lower leg pain since 2004.  On examination, the gait was non-antalgic (normal).  The range of motion (ROM) of the knees and ankles was normal and pain free.  At the MEB NARSUM examination dated 23 July 2007, 4 months prior to separation, the CI reported bilateral leg pain since 2002 which predictably began after running ½ to ¾ mile.  On examination, her gait was normal.  Tenderness was present over the anterior portion of both lower legs.  Swelling was absent.  Motor function was normal.  She was thought to have bilateral shin splints and a left tibial stress fracture.  The MEB forwarded “bilateral shin splints” and “left tibial stress fracture” for PEB adjudication.  

At the VA Compensation and Pension (C&P) evaluation performed on 15 December 2007, 1 month after separation, the CI reported continued pain aggravated by activity.  Her posture and gait were normal.  The shins were tender to palpation bilaterally.  The ROM of the knees and ankles was normal and pain free.  X-rays of both lower legs were normal.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral shin splints, left greater than right, condition at 20%, coded 5399-5312 (Analogous to Foot and Leg, Group XII Muscle function), citing one cardinal sign (fatigue/pain) of muscle disability.  The VA rated the right and left shin splints separately at 0% each, coded 5299-5262 (analogous to impairment of tibia and fibula), based on the VA C&P examination 1 month after separation, citing absence of malunion of the tibia and fibula with slight knee or ankle disability.  The VA examination was the most proximate to separation.  It showed tenderness to palpation, but normal X-rays, ROM of the knees and ankles, and a normal gait.  No route to a higher rating than the 10% adjudicated by the PEB for each lower extremity was found.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the “bilateral shin splints, left greater than right” condition.  

BOARD FINDINGS:  In the matter of the bilateral shin splints, left greater than right 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 20150609, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170005997, XXXXXXXXXXXXXXXXXX. 

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Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,