RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02003
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20060504

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Basic Airman, medically separated for “left leg pain associated with tibia and calcaneus stress reaction” with a disability rating of 0%.

CI CONTENTION:  Current condition supports a higher rating.  The CI’s 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 - 20060426	VARD - 20060808	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Leg Pain associated with Tibia and Calcaneus Stress Reaction	5099-5022	0%	No VA Placement	20060713	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Left Leg Pain.  The panel reviewed the Medical Evaluation Board (MEB) narrative summary (NARSUM) and VA Compensation and Pension (C&P) report for the relevant history and objective findings.  The CI’s left leg condition began in August 2005 during basic training without reported trauma.  A bone scan on 20 September 2005 revealed stress fractures of the right femur, left mid tibia and calcaneus, and stress changes to the feet.  The CI was briefly treated in physical therapy and then placed on convalescent leave for 30 days.  He was initially pain free, but had recurrent symptoms with increased basic training activity.
The 6 January 2005 bilateral tibia/fibula X-rays were normal.  A 26 January 2006 orthopedics examination determined the CI re-aggravation the left tibial stress fracture.  The examiner opined that the CI would require at least six additional months to improve sufficiently to return to training.

At the 5 April 2006 MEB NARSUM, 1 month before separation, the CI reported left tibial pain.  Physical examination revealed bilateral tibia (shin) tenderness with left greater than right; gait was not addressed.  There was no bilateral lower extremity edema, strength was good, and neurological and vascular examinations were intact.  Bilateral knee and ankles had full active range of motion (ROM).

At the 13 June 2006 VA Compensation and Pension (C&P) evaluation, 1 month after separation, physical examination was focused on the right femur, which was noted to be healed.  Gait was normal without use of an assistive device.  The left leg was not examined as the CI did not file a left leg VA disability claim.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left leg condition 0%, analogously coded 5099-5022 (periostitis), citing Department of Defense and Veterans Administration Schedule for Rating Disabilities guidelines.  The panel agreed that the available evidence showed a tender left leg (shin) 1 month before separation, and bilateral knee and ankle ROM was full.  The right leg focused VA examination, 1 month after separation, recorded a normal gait without use of assistance device.  The panel determined from the available evidence that the left leg condition was resolved or nearly resolved at the time of separation.  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 left leg pain.

BOARD FINDINGS:  In the matter of the left leg pain condition and IAW VASRD §4.71a, 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 20150720, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-02003.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  The Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted and I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings