RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01858
BRANCH OF SERVICE:  mARINE cORPS	SEPARATION DATE:  20080118

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Trainee, medically separated for “compartment syndrome of left lower extremity” with a disability rating of 10%.

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 - 20071130	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Compartment Syndrome, Left Lower Extremity	8799-8721	10%	No VA Examination in Evidence	
Surgical Treatment of Compartment Syndrome	Category II		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:

Compartment Syndrome of the Left Lower Extremity (LLE).  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s LLE condition began during boot camp when he presented for severe unrelenting left leg pain.  X-rays and ultrasound were negative.  Orthopedics diagnosed left leg compartment syndrome.  The CI was taken emergently to the operating room where he underwent a four-compartment fasciotomy; with delayed closure on the second post-operative day.  Following the October 2007 surgeries, he had complete resolution of his preoperative pain.

During the 12 November 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the CI reported left leg compartment syndrome and subsequent surgery with good results.  Physical examination showed LLE tenderness and healed scars with good pulses.  The MEB NARSUM examination held on the same day (within 1 month following surgery), noted left lower leg complaints with an inability to run, stand for longer than 30 minutes, or maintain a squatting position.  Physical examination showed well-healed surgical scars with a palpable fascial defect running the length of each compartment on both medial and lateral aspects of the left leg.  There was full left ankle and left knee range of motion and strength but no sensory deficit.  There was no VA examination proximate to separation in evidence.+

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the LLE compartment syndrome condition 10%, coded 8799-8721 (neuralgia; external popliteal nerve (common peroneal)).  The PEB’s Category II diagnosis of “surgical treatment of compartment syndrome” is intrinsic to the rated condition and a separate rating cannot be supported without pyramiding (VASRD §4.14); thus, it is appropriately subsumed under the same rating.

There was no residual sensory or motor loss documented at the MEB NARSUM examination, although functional loss with decreased endurance on standing was noted.  The panel adjudged the CI’s disability picture did not more nearly approximate the next higher moderate incomplete paralysis (20%) criteria under code 8721.  Alternative coding under VASRD 4.73 (schedule of ratings–muscle injuries), code 5310 (Group X; muscles) would rate no higher than moderate muscle injury (10%) IAW VASRD §4.55 and §4.56.  There was therefore no VASRD pathway to any rating higher than the 10% adjudicated by the PEB.  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 LLE compartment syndrome condition.

BOARD FINDINGS:  In the matter of the LLE compartment syndrome condition (including the Category II surgical treatment of compartment syndrome condition) and IAW VASRD §4.124a, 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 20150718, w/atchs
Exhibit B.  Service 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 USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC

		
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	     				     Acting