RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01839
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20060506

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Light-Wheel Vehicle Mechanic, medically separated for “bilateral shin splints” with a disability rating of 10%.

CI CONTENTION:  The VA rated the condition at 40%.  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 - 20060405	VARD - 20061129	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Shin Splints	5099-5022	10%	Bilateral Shin Splints	5099-5010	10%	20061011	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Bilateral Shin Splints.  The PEB combined the left and right shin conditions as a single unfitting condition analogously coded 5022 and rated 10%.  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 the PEB’s approach of 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 shin splints began in 2002 due to increased running and jumping.  The 6 January 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of bilateral lower leg pain which limited the CI from walking greater than one mile, running or jumping.  Physical examination showed a normal gait and the CI was able to toe and heel walk without complaint, but there was bilateral tibial tenderness.  He had normal-bilateral ankle strength, but painful motion was not addressed.

At the 10 October 2006 VA Compensation and Pension (C&P) evaluation, 5 months after separation, the CI reported constant daily bilateral shin pain that increased with squatting or lifting.  Physical examination showed normal gait and posture, but there was bilateral tibial tenderness.  Ankle dorsiflexion was 20 degrees (normal) and plantar flexion was 45 degrees (normal), without painful motion.  Knee range of motion (ROM) was not addressed.  Bilateral tibial X-rays were positive for stress reactive changes.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral shin splints 10%, analogously coded 5099-5022 (periostitis).  The VA also rated the bilateral shin splints 10%, analogously coded 5099-5010, (arthritis due to trauma), based on the C&P examination, citing bilateral shin pain upon use.

The panel first considered if the right or left shin splints, having been decoupled from the combined PEB adjudication, remained separately unfitting as established above.  The commander’s statement, profile and other STR evidence did not provide sufficient information which would permit the panel to discriminate the performance limitations attributable to either shin over the other.  Since undue speculation would be required to conclude that impairment from either shin would not have unacceptably interfered with MOS performance, members agreed that each shin was reasonably justified as separately unfitting.

There was no evidence of nonunion or malunion of the tibia with any degree of knee or ankle disability in either leg to justify any rating under code 5262 (tibia and fibula, impairment).  There was no evidence of limited ankle or knee ROM to rate under any of the respective codes in either leg and no evidence of painful motion to either knee or ankle proximate to separation to support a 10% rating based on painful motion with functional loss IAW §4.59, §4.40 and §4.45.  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 shin splints.

BOARD FINDINGS:  In the matter of the bilateral shin splints 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 20170301, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180005424, 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