RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01602
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050408

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Patriot Fire Control Enhanced Operator, medically separated for “chronic lower extremity pain,” with a disability rating of 0%.

CI CONTENTION:  The CI’s condition continues to worsen and negatively impacts daily activities.  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 - 20050323	VARD – No VA Claim	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Lower Extremity Pain	5099-5022	0%	No VA Claim	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  --	

ANALYSIS SUMMARY:  

Chronic Lower Extremity Pain Diagnosis.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s lower extremity condition began in November 2003.  Although there was no specific trauma, the CI reported left and right ankle pain.  Bone scans showed right proximal tibia stress fracture and bilateral ankle and feet stress reactions.  Despite being placed on 4 weeks of strict physical limitations, the bilateral lower leg, ankle, and feet pain did not resolve.  A permanent profile for the lower extremities was applied and the CI was referred for an MEB.  The MEB forwarded “chronic lower leg and ankle pain as well as symptomatic Pes Planus” for PEB adjudication.  On 23 November 2004, a bone scan demonstrated a Grade 1 stress fracture in the right proximal tibia and stress reaction in the ankles and in the feet. 

The MEB NARSUM examination on 17 February 2005, 2 months prior to separation, noted complaints of chronic lower leg pain and symptomatic pes planus.  Physical examination showed normal, full, painless range of motion of both hips, knees, ankles, and all toes.  The neurovascular and muscle strength findings were normal.  There was not any limb or gait discrepancy.  There was no VA Compensation and Pension (C&P) evaluation in evidence.  

The Board directed attention to its rating recommendation based on the above evidence. The PEB rated the chronic lower extremity pain condition 0%, coded 5099-5022 (Periostitis), citing “stress fractures of tibias on bone scan only and the pain persists after convalescence.”  Although there were reports of pain with use, there was no evidence of painful motion to support a 10% rating IAW VASRD §4.59.  Mild Pes planus was noted on the entrance examination and there was no evidence that the service aggravated the condition beyond the natural progression of the disease.  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 chronic lower extremity pain condition.  

BOARD FINDINGS:  In the matter of the chronic lower extremity pain 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 20150616, w/atchs
Exhibit B.  Service Treatment Record

AR20170006645, 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