RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00659
BRANCH OF SERVICE:  Army  	SEPARATION DATE:  20070620 

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty O3, Ordnance Officer, medically separated for “bilateral anterior compartment syndrome” with a disability rating of 0%.   

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 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 - 20070515	VARD – 20070829 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Anterior Compartment Syndrome	5399-5312	0%	Left Lower Extremity Compartment Syndrome	5399-5312	0%	20070308	
			Right, Lower Extremity Compartment Syndrome	5399-5312	0%	20070308	
Past Cervical Dysplasia	Not Unfitting	Dysplasia, Cervix	7612	NSC	20070308	
Bursitis, Right Hip	Not Unfitting	Bursitis, Right Hip 	5019	0%	20070308	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10% 	

ANALYSIS SUMMARY:  

Bilateral Anterior Compartment Syndrome.  The PEB combined the right and left lower extremity conditions under a single disability rating, coded 5399-5312 (analogous to group XII muscle injuries) and rated 0%.  This approach by the PEB not uncommonly reflected its judgment that the constellation of conditions was unfitting, and there was no need for separate fitness adjudications.  The panel’s initial charge in this case was therefore directed at determining if combining conditions under a single rating was justified in lieu of separate ratings.  When considering a separate rating for each condition, the panel considers each bundled condition to be reasonably justified as separately unfitting unless a preponderance of evidence indicates the condition would not cause the member to be referred into the DES or be found unfit because of physical disability.  When the panel recommends separate fitness recommendations in this circumstance, its recommendations may not produce a lower combined rating than that of the PEB.  

According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s bilateral anterior compartment syndrome began in 2005 without specific injury or trauma.  At the 5 January 2007 orthopedics evaluation, 6 months prior to separation, the surgeon advised against surgery.  The 24 April 2007 MEB NARSUM examination, 2 months prior to separation, noted complaints of pain in both lower legs with running, walking too much or rucking.  Physical examination showed a normal gait.  No examination of the lower legs was recorded.  The examiner made reference to a bone scan which is not in evidence and did not show any shin pathology.  

At the 8 March 2007 VA Compensation and Pension (C&P) evaluation, 4 months before separation, the CI reported pain and numbness of her lower legs with prolonged standing, running or walking.  Physical examination showed full range of motion of all joints, normal muscle strength in all extremities and no sensory deficits.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral anterior compartment syndrome condition 0% coded analogously to 5312.  The VA rated the left and right lower extremity compartment syndrome conditions 0% each, coded analogously to 5312, based on the C&P examination, citing slight muscle disability.  

The panel first considered if each lower leg condition, when decoupled from the combined PEB adjudication, remained separately unfitting as established above.  Both legs were considered to fail retention standards and were implicated in the NARSUM.  The commander’s statement and other STR evidence did not provide any information which would permit the panel to discriminate the performance limitations attributable to either leg over the other.  Since undue speculation would be required to conclude that impairment from either leg would not have unacceptably interfered with MOS performance, members agreed that each leg was reasonably justified as separately unfitting.  

The panel then considered its rating recommendation for each leg based on the above evidence.  Panel members agreed there was no evidence of weakness or limitation of motion of either ankle or toes to justify a rating higher than 0% under code 5312 for slight disability of each unfitting lower leg.  There was no evidence of stress fracture or other injury to the bones of either lower leg to validate a rating under code 5262 (tibia and fibula, impairment of).  Likewise, there was no evidence of muscle weakness or abnormal sensation to authenticate a rating under any VASRD §4.124a neurologic code in either leg.  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 anterior compartment syndrome.  

Contended PEB Conditions:  Past Cervical Dysplasia and Right Hip Bursitis.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  Neither of the conditions were profiled, implicated in the commander’s statement nor judged to fail retention standards.  There was no performance-based evidence from the record that either of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for either of the contended conditions and so no additional disability ratings are recommended.  
BOARD FINDINGS:  In the matter of the bilateral anterior compartment syndrome and IAW VASRD §4.73, the panel recommends no change in the PEB adjudication.  In the matter of the contended cervical dysplasia and right hip conditions, the panel recommends no change from the PEB determinations as not unfitting.  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 20170215, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20180004729, 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