RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00699
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20081014

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Motor Transport Operator, medically separated for “chronic right lower leg pain” with a 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 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 - 20080702	VARD - 20090629	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Lower Leg Pain	5299-5262	10%	Lower Right Leg Stress Fracture	5299-5262	NSC	STR	
Lumbago	Not Unfitting	Lower Back Strain	5237	NSC	STR	
Foot Pain, Left and Right	Not Unfitting	No VA Placement	
Shin Splints, Left	Not Unfitting	No VA Placement	
GERD	Not Unfitting	No VA Placement	
Headaches	Not Unfitting	No VA Placement	
Scoliosis	Not Unfitting	No VA Placement	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0% 	

ANALYSIS SUMMARY:  

Chronic Right Lower Leg Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s right leg condition began in May 2007 after doing physical training while deployed.  Bone scan showed a stress fracture of the distal right tibial diaphysis.  The 28 May 2008 MEB NARSUM examination, 5 months prior to separation, noted complaints of bilateral leg pain, right side worse than left.  The CI reported difficulty running, but could walk 5 to 6 miles, drive and work.  The condition became symptomatic with high impact activities like running.  The examiner noted a lumbering stride but an otherwise normal examination.  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 leg condition 10%, coded 5299-5262 (analogous to impairment of the tibia and fibula), citing residual pain on motion of the ankle without restricted motion.  The VA denied service-connection for the right leg condition.  Although the language of code 5262 is specific for complications of a more significant fracture, the panel concluded that analogous application of the code, IAW VASRD §4.20 (analogous ratings) and based on the underlying pathology of the tibia bone, was the best fit with regard to symptomatology and functional limitations.  The MEB NARSUM indicated the pain returned almost exclusively with high impact activities, which most closely approximated “slight” knee or ankle disability.  Members therefore agreed that a 5299-5262 coding approach was justified, and that a 10% rating was adequately supported by the evidence.  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 right leg condition.  

Contended PEB Conditions:  Left and Right Foot Pain, Left Shin Splints, GERD, Headaches, Lumbago and Scoliosis.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  With the exception of shin splints and foot pain the conditions were not profiled.  None of the conditions were implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that any 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 any of the contended conditions and so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the right leg condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended foot pain, shin splints, GERD, headaches, lumbago and scoliosis, 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 20170216, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180004747, 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