RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01487
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081015

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 “bilateral lower leg pains,” with a disability rating of 20%.

CI CONTENTION:  The CI contends that his condition continues to worsen and impact his daily living.  He additionally request all conditions be considered. 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 - 20080710	VARD – No VA Exam	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Lower Leg Pain	5299-5262	20%	No VA Entry	
Right knee Pain	Not Unfitting		
COMBINED RATING:  20%		COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Bilateral Lower Leg Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral lower leg condition began in July 2007 after while performing physical training (PT).  He was found to have a stress fracture of the right shin bone (tibia) and bilateral shin splints on bone scan.  He was treated with duty restrictions and no running for 2 months.  However, his symptoms recurred once he resumed running.  His profile was extended for another 6 weeks on 6 November 2007.  On examination, he was tender over the shins bilaterally, but his gait was normal.  The CI did not follow-up until 26 March 2008 when he reported ongoing pain and requested a new profile.  The bone scan was repeated on 2 April 2008.  It showed right > left shin splints, improved from the prior scan.  The previously noted fracture was not recorded.  The CI was then referred for MEB for persistent shin splints.  

At the MEB examination (recorded on DD Forms 2807 and 2808) dated 21 May 2008, 5 months prior to separation, the CI was tender over both shins below the knees.  The MEB NARSUM examination on 16 June 2008, 4 months prior to separation, noted complaints of bilateral shin splints despite profile restrictions, albeit improved.  The right knee had also been painful since July 2007, but currently was “not a problem” as his activity level was low.  His pain level for the shin splints was related to his activity level.  He was working on administrative duties and also walked on the track for unit physical training.  Both increased his symptoms though.  He reported that these had been stable for the past several months.  He could walk ¾ mile before he needed to stop due to pain.  On examination, both shins and surrounding soft tissue were tender to palpation.  The range of motion of the ankles and knees was normal.  There was no pain in either the ankles or knees.  His gait was initially normal, but favored the right side as he walked.  The examination was otherwise unremarkable.  His prognosis was thought to be good.  He was diagnosed with a closed stress fracture of the right and left tibia and the MEB forwarded this diagnosis for PEB adjudication.  There was no VA examination in evidence proximate to separation.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral lower leg pain condition at 10% each, for a 20% total with the bilateral factor applied, coded 5299-5262 (analogous to slight impairment of the tibia and fibula).  The Board considered the impairment and determined that the ability to walk ¾ mile was more consistent with a mild than a moderate impairment under the 5262 code.  The Board also considered the code 5022 (periostitis), but this did not support a higher rating.  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 lower leg pain condition.  

Contended PEB Conditions:  Right Knee Pain.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The right knee pain was not profiled, implicated in the commander’s statement, or judged to fail retention standards.  There were no records in evidence that showed that the CI sought treatment for knee pain and no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the bilateral lower leg pains condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended right knee pain conditions, the Board unanimously recommends no change from the PEB determination as not unfitting.  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 20150611, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170006609, 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,					       
						      					
Enclosure