RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02290
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050317

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Infantry Recruit, medically separated for “chronic bilateral leg pain, due to tibial stress fractures,” with a disability rating of 10%.  

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 - 20050124	VARD - 20050505	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic bilateral Leg Pain Due to Tibial Stress Fx	5099-5003	10%	S/P Stress Fx, Right Distal Tibia	5299-5262	0%	20050118	
			S/P Stress Fx, Left Mid-Tibia	5299-5262	0%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Bilateral Leg Pain Due to Tibial Stress Fractures.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral leg pain condition began in March 2004 during basic training.  X-rays in March 2004 showed bilateral tibial stress fractures.  Bone scan in October 2004 was consistent with bilateral shin splints with no evidence of stress fracture.  

During the October 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported bilateral tibial stress fractures and bilateral knee pain.  Physical examination showed tenderness to the right distal half of the tibia and tenderness of the distal third of the tibia.  The 2 November 2004 MEB NARSUM examination, 4 months prior to separation, noted complaints of chronic leg pain due to bilateral tibial stress fractures.  The CI had pain with activities and was unable to run.  Physical examination showed tenderness to both tibias.  The CI had full range of motion of the knees, ankles, and feet.  There were no skin or neurovascular changes.  

At the 18 January 2005 VA Compensation and Pension (C&P) evaluation, 2 months before separation, the CI reported bilateral tibial pain without current treatment or functional impairment.  Physical examination showed a normal gait with normal findings of the tibias.  Range of motion of bilateral knee and ankle joints was full and without painful motion.  There were no additional limitation by pain, fatigue, weakness, lack of endurance or incoordination after repetitive use.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral leg condition 10%, coded 5099-5003 (degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA rated the left and right tibial stress fracture conditions 0% each, both coded 5299-5262 (impairment of the tibia and fibula), based on the C&P examination 2 months before separation, citing no evidence of an unhealed stress fracture or impairment to the knees or ankles.  The pre-separation VA examination was closest to separation and therefore had the highest probative value for rating at separation.  Neither tibial condition was associated with at least slight knee or ankle disability, and therefore did not reach the 10% criteria under code 5262 (impairment of the tibia and fibula) and would each rate at 0% IAW §4.31 (a no-percent rating).  Therefore, there was no avenue to any rating higher than that awarded 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 chronic bilateral leg pain due to tibial stress fractures condition.  

BOARD FINDINGS:  In the matter of the chronic bilateral leg pain due to tibial stress fractures 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 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 20150825, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170012177, 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,