RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00243
BRANCH OF SERVICE:  navy 	SEPARATION DATE:  20050501

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Communications and Intelligence Specialist, medically separated for “bilateral tibial diaphysis stress fracture” rated 0% and 10%, right and left, respectively, with a combined disability rating of 10%.  

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 - 20050304	VARD - 20050711	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Tibial Diaphysis Stress Fracture 	5003-5262	0%	Bilateral Tibial Stress Fracture	5262	0%	20050510	
		10%					
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Bilateral Tibial Diaphysis Stress Fracture.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI initially complained of left shin pain in October 2004 after running.  She was treated with medications and ice packs, but had persistent pain.  Her pain persisted and a bone scan on 2 November 2004 identified stress fractures of each tibia (shin splints).  Despite medications and duty limitations, her pain failed to improve.  Persistent bilateral stress fractures, left greater than right, were seen on a repeat bone scan on 29 December 2004.  

The 2 February 2005MEB NARSUM examination, 3 months prior to separation, noted minimal improvement with treatment and that the CI was limited to running one-quarter mile and unable to walk or stand for an undefined prolonged period.  On physical examination, the tibial shafts (shins) were tender bilaterally.  Knee flexion and ankle plantar (toes down) flexion were both slightly reduced, but pain-free and symmetric.  Her gait was normal, the joints were stable and neurological examination was intact.  At the 10 May 2005 VA Compensation and Pension (C&P) evaluation performed, 9 days after separation, the CI reported bilateral shin pain, but did not take medications or have other treatment.  The physical examination showed a normal gait.  There was no tenderness, swelling or deformities noted.  X-rays were normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral tibial diaphysis stress fracture conditions 0% (right) and 10% (left), both coded 5003-5262 (degenerative arthritis - impairment of the tibia and fibula).  The VA rated the bilateral tibial stress fracture condition 0%, coded 5262, based on the C&P examination 10 days after separation, citing absence of malunion of the tibia and fibula with slight knee or ankle disability.  The panel observed that the C&P examination was normal with only subjective complaints.  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 bilateral tibial diaphysis stress fracture condition.  

BOARD FINDINGS:  In the matter of the bilateral tibial diaphysis stress fracture 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 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 20160412, 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 USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN

		
							XXXXXXXXXXXXXXXXXX
	     				            Principal Deputy, Assistant 
						Secretary of the Navy
						(Manpower and Reserve Affairs)
						Performing the Duties of the 
						Assistant Secretary of the Navy
						(Manpower and Reserve Affairs)