RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2016-01667
BRANCH OF SERVICE:  Marine Corps 	

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E3, Supply Administrative Clerk, medically separated for “status post right tibia open fracture treated with intramedullary rod subsequent removal” with a disability rating of 10%.  

CI CONTENTION:  No specific contention 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 - 20041109	VARD - 20050613	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Status Post Right Tibia Open Fracture…	5099-5003	10%	Status Post Fracture, Right Tibia and Fibula	5262	NSC	20050408	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Status Post Right Tibia Open Fracture.  According to the service treatment record and MEB narrative summary (NARSUM), the CI fractured his right tibia and fibula in a motorcycle accident in July 2002, and underwent an open fixation of the tibia with an intramedullary rod.  He continued to experience pain and the rod was removed on 26 September 2003 with no subsequent resolution of symptoms.  The 28 August 2004 MEB NARSUM examination, 4 months prior to separation, noted complaints of difficulty with running due to knee and ankle pain.  Physical examination showed right knee flexion to 130 degrees (normal 140), extension to 0 degrees (normal) and full range of motion (ROM) of the ankle.  There was tenderness over the previous fracture site.  

At the 8 April 2005 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the CI reported right lower leg pain at the mid-shin aggravated by running, jogging and jumping.  Physical examination showed a normal gait and mild tenderness over the previous fracture site.  Right knee flexion and extension were normal, with a “pulling pain” at the end of flexion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right leg condition 10%, analogously coded 5099-5003 (arthritis, degenerative), citing knee ROM of 0-130 degrees and full ankle ROM.  The VA determined the right leg condition was not service-connected, citing no evidence the condition was aggravated by active military service.  Members agreed there was no limitation of knee motion, which supported a rating under the diagnostic codes for limitation of flexion (5260).  There was no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258), or history of surgery to remove a meniscus (5259) to support a rating under that code.  There was also no evidence of nonunion or malunion of the tibia or fibula to support consideration under 5262.  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 right leg condition.  

BOARD FINDINGS:  In the matter of the status post right tibia open fracture condition 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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161031, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs 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 USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN

							XXXXXXXXXXXXXXXXXX
	     				                        Assistant General Counsel
						           (Manpower and Reserve Affairs)