RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02177
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040804

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Signal Support Systems Specialist, medically separated for “bilateral shin splints” with a disability rating of 0%.  

CI CONTENTION:  The CI made no specific contention.  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 - 20040618	VARD - 20041215	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Shin Splints	5022	0%	Bilateral Tibial Stress Fractures	5399-5312	NSC	20041215	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Bilateral Shin Splints.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s shin splints condition began early in basic training without specific injury or trauma.  A bone scan on 9 June 2003 showed bilateral uptake about the soft tissues of both ankles without changes of shin splints.  She was treated conservatively with medications, duty limitations, and physical therapy but her symptoms persisted.  X-rays of the lower extremities were initially normal.  A repeat bone scan on 4 September 2003 showed right  greater than left bilateral stress fractures as well as periosteal (the soft tissue lining over the bones) stress reactions (shin splints).  She continued conservative treatment, but a repeat bone scan on 1 December 2003 showed persistent stress fractures.  A primary care note a few days later recorded that she was not symptomatic with normal activity.  

At the MEB examination (recorded on DD Forms 2807 and 2808) dated 19 April 2004, 4 months prior to separation, the CI reported ongoing bilateral lower leg pain with excessive activity.  Both shins were tender to palpation.  The MEB NARSUM was dated 3 May 2004, 3 months prior to separation, and referenced an examination accomplished on 15 April 2004.  It noted that she had not recovered sufficiently to accomplish an alternate physical fitness test.  On examination, the gait and station were normal.  The lower legs were normal to examination other than mild tenderness over the shins (anterior tibiae) bilaterally.  She could walk on her heels and toes.  There was full range of motion (ROM) of the knees and ankles.  X-rays of the right and left legs were recorded as normal.  The MEB forwarded bilateral shin splints to the PEB for adjudication.  The CI contested the MEB findings and stated that she could perform an APFT with little problem and also noted that her profile restrictions were incorrect and excessive.  She requested consideration for reclassification.  

The VA Compensation and Pension (C&P) orthopedic evaluation was performed on 6 October 2004, 2 months after separation.  The CI worked in sales and had right hip pain if she stood for protracted periods of time.  She also reported pain over the shins with running.  On examination, her gait was normal without an assistive device.  The ROM of both the knees and ankles was normal.  Examination of both lower extremities was normal; tenderness was not recorded.  X-rays were normal.  She was thought to have a normal examination without residuals from the bilateral stress fractures.  At a general C&P examination on 16 October 2004, the CI had a normal posture and gait.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the shin splints condition 0%, coded 5022 (periostitis), citing no limitation of motion.  The VA did not service connect the shin splints condition, noting that the condition had resolved.  The NARSUM examination was normal other than mild bilateral tenderness of the shins.  The CI reported that she thought she could pass an APFT.  The VA examination, only 2 months after separation, showed that the condition had resolved.  The evidence shows that the bilateral shin splint condition was resolved or nearly resolved at the time of separation.  No route to a higher rating than the 0% adjudicated by the PEB was found.  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 shin splints condition.  

BOARD FINDINGS:  In the matter of the shin splints 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 modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150814, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170014671, XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX

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