RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01970
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20020228

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Warehouse Clerk, medically separated for “bilateral calf pain” with a disability rating of 20%.

CI CONTENTION:  The CI has more conditions than we he was in the service and they are worsening.  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 - 20011227	VARD -20020326	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Calf Pain	5399-5312	10%	Compartmental Syndrome, Right Leg	5311	10%	20020116	
Left Calf Pain	5399-5312	10%	Compartmental Syndrome, Left Leg	5311	10%		
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:  

Bilateral Calf Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral calf pain condition began in 1999 with an insidious onset, while running.  A muscle biopsy performed 16 May 2000 showed mild grouped atrophy “consistent with neurogenic causation” and small type 2 fibers (small fast twitch fibers).  At a neurology evaluation on 14 August 2000, the examiner referenced “mildly elevated compartmental pressures measured by an orthopedist.”  Physical examination showed a “somewhat” antalgic gait and difficulty doing tow ups due to pain.  The examiner opined that the bilateral calf pain was related to compartment syndrome (increased pressure within the muscle compartments of the leg).  

The 21 September 2001 MEB NARSUM examination, 5 months prior to separation, noted complaints of bilateral burning calf pain.  The CI reported increased bilateral calf pain with walking three flights of stairs and no more than half mile.  Physical examination showed a slightly abnormal gait, slight atrophy of the calf muscles, significant tenderness to palpation over the calves, 4/5 plantar flexion, and significant pain with less than 5 toe raises.  

At the 16 January 2002 VA Compensation and Pension (C&P) evaluation, 1 month before separation, the CI reported muscle pain and fatigue in his calves.  He reported decreased motion at the knee and ankles secondary to pain.  Physical examination showed that the CI walked with an abnormal gait as he did not flex his hips and knees normally, and shifted his weight abnormally. Range of motion of the hips, knees and ankles were normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral calf pain condition 10% for each leg, for a combined 20%, coded 5399-5312 (the foot and the leg, group xii function).  The VA rated each leg for compartment syndrome at 10% each, combined 20%; coded 5311 (the foot and the leg, group xi function), based on the C&P examination 1 month before separation, citing moderate muscle disability, loss of power, weakness, fatigue-pain, impairment of coordination or uncertainty of movement.  Panel members agreed that evidence (mild muscle atrophy, slightly decreased plantar flexion, and a mildly antalgic gait) supports a 10% rating for moderate muscle impairment.  The evidence did not support a higher rating of 20% for moderate severe muscle dysfunction.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the bilateral calf pain condition.  

BOARD FINDINGS:  In the matter of the bilateral calf 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 that 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 20150711, 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:

		- XXXXXXXXXXXXXXXXXX, former USMC
		-XXXXXXXXXXXXXXXXXX, former USMC
		-XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN

	
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	     				  Acting