RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02264
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050413

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 “chronic bilateral lower extremity pain” with a disability rating of 0%.  

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 – 20050324	VARD - 20051102	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Bilateral Lower Extremity Pain	5022	0%	Stress Reaction, Left Foot	5099-5022	0%	STR	
			Stress Reaction, Right Hip to include Groin	5022	0%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Bilateral Lower Extremity Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left foot and bilateral groin conditions began in November 2004 during the second week of Basic Training.  Radiographic studies from 3 December 2004 showed a normal right hip and a left foot lucency at the base of the 5th metatarsal. 

The 7 March 2005 MEB NARSUM examination, 1 month prior to separation, noted complaints of right groin and left foot pain increased with physical activity.    Physical examination showed a normal gait.  There was tenderness in the right inguinal fold and range of motion (ROM) of the right hip was “normal and full.”  Heel tap, leg motion (FABER) and straight leg raise were negative.  The left foot showed localized tenderness to the base of the 5th metatarsal without swelling or discoloration.  There were no neurovascular deficits.  There was no VA examination in evidence proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic bilateral lower extremity conditions 0%, coded 5022 (periostitis), citing pain and profile prevented re-entry into training or completing APFT.  The VA rated the left foot stress reaction condition 0% coded analogously 5099-5022, and the right hip stress reaction (to include groin) condition 0% coded 5022, citing failure to report for a VA examination and lack of current medical evidence for the CI’s current condition.  

Considering the right hip/groin condition, there was no painful or limited motion of the right hip, no muscle injury, and no joint degeneration for any rating higher than 0%.  The left foot 5th metatarsal stress fracture did not have any malunion or nonunion that was at least moderate, it did not result in a weak foot, or rise to the level of a moderate foot injury for any rating higher than 0%.  When both conditions are considered together, there was no evidence for degenerative changes to meet the 10% rating under 5003 (arthritis, degenerative) for X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups.  

Although the PEB bundled the right hip/groin condition and left 5th metatarsal stress fracture, there was no mechanism for any rating higher than 0% for either condition either separately or combined.  There was therefore no VASRD mechanism for any rating higher than the 0% adjudicated by the PEB.  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 chronic bilateral lower extremity pain condition.  

BOARD FINDINGS:  In the matter of the chronic bilateral lower extremity pain condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There were 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, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

	

AR20170012162, 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