RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01506
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20041011

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, COMSEC Radio Repairer, medically separated for “left lower leg pain as a residual of healed tibial stress fracture” with a disability rating of 0%.

CI CONTENTION:  Current condition supports a higher rating. 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 (VA), 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 - 20040830	VARD - 20130617	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Lower Leg Pain…	5099-5003	0%	Residuals Stress Fractures Left Lower Extremity	5262	0%	20130307	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Left Lower Leg Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI first presented for bilateral lower leg pain on 7 June 2003.  X-rays were normal.  She was treated with duty restrictions and physical therapy, but her pain persisted.  A bone scan on 2 July 2003 showed multiple small bilateral tibial (shin bone) stress fractures.  She continued limited activities, but had recurrent pain every time she tried to run.  A repeat bone scan on 11 February 2004 showed a subtle uptake in the proximal right tibia (the shin bone just below the knee) which was consistent with a nearly healed stress fracture; still causing pain while left tibia was normal.

The 23 June 2004 orthopedic clinic evaluation revealed “normal” range of motion (ROM) for the hips, knees, and ankles bilaterally.  There was tenderness over the right and left tibias.  Strength was normal.  The 26 June 2004 MEB NARSUM examination, 4 months prior to separation, noted complaints of bilateral lower leg pain with exertion, greater on the left.  Physical examination showed a normal gait and station.  The left ankle ROM was dorsiflexion to 20 degrees (normal 20) and plantar flexion was 50 degrees (normal 45).  There was no redness or swelling along the anterior tibia nor tenderness.  Left knee or right lower extremity ROMs were not addressed.  Strength was specifically noted to be normal and atrophy absent.  The remainder of the physical examination was “within normal limits.”  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 left lower leg condition 0%, analogously coded 5099-5003 (degenerative arthritis), citing application of the US Army Physical Disability Agency pain policy.  The VA also rated the left lower extremity condition 0%, coded 5262, (tibia and fibula, impairment), based on the C&P examination over 9 years after separation, citing no residuals and no knee or ankle disability.  The panel agreed, a bone scan 8 months prior to separation showed the left tibia as normal.  The MEB NARSUM examination of the lower extremities, most proximate to separation, was essentially normal.  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 lower left leg pain condition.

BOARD FINDINGS:  In the matter of the lower left leg pain 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 recommends t 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 20161006, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20180001633, 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