RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01673
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20080514

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Trainee, medically separated for “left lower extremity pain and weakness” 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 - 20080417	VARD - 20081230	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Lower Extremity Pain and Weakness	5399-5312	10%	Left Lower Extremity Anterior Compartment Syndrome	8723	10%	20081105	
COMBINED RATING:  10%	Combined Rating Of All VA Conditions:  20%	

ANALYSIS SUMMARY:  

Left Lower Extremity Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left lower extremity pain began in October 2007 while running.  Compartment pressures of the leg were elevated and he underwent a fasciotomy 25 January 2008, which did not result in resolution of symptoms.  There was no further surgical indication.

The 10 April 2008 MEB NARSUM examination, 1 month prior to separation, noted CI complaints of constant left lower extremity soreness with sitting, and pain aggravated by weight bearing.  Physical examination showed an antalgic gait with tissue firmness and left anterior shin tenderness near the surgical scar.  There was decreased left lower leg strength rated as 4/5 in flexion and extension.  

At the 5 November 2008 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported pain in the left lower leg that was worse with walking more than 30 minutes and prevented him from running.  Physical examination demonstrated an antalgic gait favoring the left leg.  There was a 5.2cm X 4mm tender surgical scar on the left lower mid anterior leg with an indentation, but no atrophy, and both calves were symmetrical in circumference.  Muscle strength during left ankle dorsiflexion was 4/5 with no sensory loss noted.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left lower extremity condition 10%, analogously coded as 5399-5312 (muscle injuries, group XII), citing pain, weakness and lack of endurance.  The VA also rated the left lower extremity condition 10%, coded 8723 (anterior tibial nerve (deep peroneal) neuralgia), based on the C&P examination, citing incomplete-moderate paralysis of foot movements.  Panel members agreed that the mild lower leg weakness as recorded on the MEB NARSUM and VA examinations supports a 10% “moderate” muscle injury rating, but no higher, as adjudicated by the PEB.  There was no evidence of stress fracture or other injury to the bones of the lower leg to support a rating under code 5262 (tibia and fibula, impairment).  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 left lower extremity condition.

BOARD FINDINGS:  In the matter of the left lower extremity pain and weakness condition and IAW VASRD §4.73, 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.

AR20180011412, 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.