RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE: PD-2016-01062 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20040514

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Electrical/Mechanical Equipment Repairman, medically separated for “right fibula shaft periostitis” with a disability rating of 10%.

CI CONTENTION: No specific contention was made. 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 Medical Evaluation Board (MEB), but determined by the PEB 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. The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate. The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.

RATING COMPARISON:

SERVICE PEB - 20040420	VARD - 20040818	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Fibula Shaft Periostitis	5022-5003	10%	Stress Fracture of Right Ankle Right Leg, and Left Foot	5099-5019	NSC	STR	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: NSC	
	
ANALYSIS SUMMARY:

Right Fibula Shaft Periostitis. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s lower extremity condition began in September 2003 during boot camp conditioning with no history of trauma or injury. A bone scan on 23 September 2003 revealed right tibia, right ankle and left first metatarsal stress fractures, and she was placed on stress fracture rehabilitation protocol, and progressed slowly. In December 2003, the CI was advanced to full duty status, but one day later, she presented with recurring pain and was placed on light duty status for suspected patella femoral syndrome. In March 2004, the CI continued to complain of left hip and knee pain along with bilateral foot pain. A repeat bone scan in November

2003 revealed marked improvement suggesting healing or healed fractures in the proximal right tibia and left first metatarsal. In February 2004, a bone scan showed minimal linear uptake in the mid third of the right tibia suggestive for a “shin splint on the right side.” Recovery was likely to take 6 months to a year preventing her from progressing in boot camp training.

The 17 March 2004 MEB NARSUM examination, 2 months before separation, noted complaints of bilateral lower extremity pain, and the examiner recorded bilateral tibial tenderness at mid shaft. At the 26 April 2004 sports medicine examination, the CI reported lower extremity pain rated at 3/10. Physical examination showed bilateral tibial shaft tenderness; painful motion was not addressed. There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the “right fibula shaft periostitis” 10%, coded 5022-5003 (periostitis-degenerative arthritis). The VA did not service connect the right tibial condition. Members first noted that all of the bone scans referenced in the STR documented stress fractures of the right tibia, not the fibula, and thus considered this a likely error. The panel agreed there was no evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45). There likewise was no limitation of motion which attained a 10% rating under the diagnostic codes for limitation of flexion or extension (5260, 5261). There was also no fracture, nonunion or malunion of the tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262). After due deliberation, considering all 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 right tibial condition.

BOARD FINDINGS:      In the matter of the right tibial (“fibula’”) shaft periostitis and IAW VASRD
§4.71a, the panel recommends no change in the PEB adjudication. There are no other conditions within the panel’s scope of review for consideration. Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.

2	PD-2016-01062

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN   REPLY  REFER  TO,
1850
CORB: 003 20May20

From: 

Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 13 Nov 18

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.