RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01726
BRANCH OF SERVICE:  NAVY 	SEPARATION DATE:  20030903

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Machinist Mate, medically separated for “chronic left leg pain” and “chronic right leg pain” rated at 10% each, with a combined disability rating of 20%.  

CI CONTENTION:  “Review all conditions.”  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 - 20030804	VARD - 20041006	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Leg Pain	5399-5312	10%	Bilateral Pes Planus with Residual Anterior Leg Discomfort	5276	0%	20040619	
Chronic Right Leg Pain	5399-5312	10%					
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Left Leg and Right Leg Pain Conditions.  Given their shared histories, examinations and similarities with respect to pathology, the evidence for the left and right leg pain conditions are addressed and presented together, with attendant recommendations regarding fitness and rating provided separately.  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left and right leg pain conditions began in February 2001 with no specific injury or trauma noted.  During the 8 May 2003 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the physical examination showed bilateral medial tibial tenderness.  The 14 May 2003 MEB NARSUM examination, 4 months prior to separation, noted complaints of inability to do shipboard duties due to bilateral lower leg pain.  Physical examination showed tenderness to the calves diffusely with no other abnormal lower extremity findings.  

At the 19 June 2004 VA Compensation and Pension (C&P) evaluation, 9 months after separation, the CI reported bilateral shin pain since boot camp that was worse with prolonged standing, running, jogging or walking.  Physical examination showed a normal evaluation with no areas of tenderness in either shin.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left and right leg pain conditions 10% each, coded 5399-5312 (analogous to moderate injury of the Group XII muscles).  The VA combined the left leg pain condition with the right leg pain condition, rating them bilaterally at 0%, coded 5276, (flatfoot, acquired), based on the C&P examination 9 months after separation, citing no objective functional impairment, painful motion, weakness, fatigue or incoordination.  

There was no evidence of nonunion or malunion of the tibia with any degree of knee or ankle disability in the left leg to justify any rating under code 5262 (tibia and fibula, impairment).  There was no evidence of limited range of motion (ROM) of the knee or ankle or evidence of painful motion to rate under any of the respective codes in either leg.  Antalgic gait was not recorded on any examination proximate to separation to provide evidence of painful motion with functional loss supporting a minimum 10% rating (based on §4.59, §4.40 and §4.45).  Panel members agreed the degree of disability in the muscles of dorsiflexion of the ankle or anterior muscles of the lower leg did not rise to the level of moderately severe to justify the next higher 20% rating.  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 chronic left leg or right leg pain conditions.  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 or right leg chronic pain conditions.  

BOARD FINDINGS:  In the matter of the chronic left leg pain condition and IAW VASRD §4.73, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the chronic right leg pain condition and IAW VASRD §4.73, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends there be 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 20150630, 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:

		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC

		
	XXXXXXXXXXXXXXXXXXX  					
         Acting