RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01862
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041125

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Network Switching Systems Operator/Maintainer, medically separated for “bilateral shin splints” with a disability rating of 0%.  

CI CONTENTION:  He requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20040930	VARD - 20041211	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Shin Splints	5022	0%	Chronic Bilateral Shin Splints	5312-5311	0%	20040720	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Bilateral Shin Splints.  The PEB combined the right and left shin splint conditions under a single disability rating, coded 5022 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 adjudicated by the PEB.  The evidence for the right and left shin splint conditions are presented together, with attendant recommendations regarding separate unfitness, and separate rating if indicated.  

According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s shin splints began in October 2001 during basic training while running.  A bone scan showed resolving bilateral shin splints, but he continued to have leg pain.  During the 8 April 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 7 months prior to separation, the CI reported the inability to use his legs because of shin splints but the physical examination was unremarkable.

At the 20 July 2004 VA Compensation and Pension (C&P) examination, 4 months before separation, the CI reported constant leg pain, the inability to walk or run for long distances or stand for long periods of time, and lost time from work.  The examiner noted normal gait and posture and no lower extremity edema.  There was bilateral tibia and fibula tenderness and full range of motion of both knees and ankles.

The 26 August 2004 MEB NARSUM examination, 3 months before separation, noted complaints of chronic bilateral leg pain.  Physical examination revealed mild point tenderness along the left anterior tibia with deep palpation, but no swelling or redness. Right lower extremity findings were similar.  The examiner stated, “He [CI] has been unable to deploy with his unit because of his chronic bilateral leg pain which seems to have only minimal objective findings.” 

The panel first considered whether each shin splint condition, when decoupled from the combined PEB adjudication, remained separately unfitting as established above.  Both shin splints 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 shin splint would not have unacceptably interfered with duty performance, members agreed that each shin splint was reasonably justified as separately unfitting.  

The panel then considered its rating recommendation for each shin splint based on the above evidence. As noted above, the PEB bundled the bilateral shin splints and applied a single 0% rating, coded 5022 (periostitis), citing no limitation of motion.  The VA also bundled the bilateral shin splints and applied a single 0% rating, dual coded 5312-5311 (group XII and group XI muscle injuries), based on the C&P examination, citing slight muscle disability with evidence of tenderness along both shins and the diagnoses of shin splints, opined to be a transitory condition.  Members agreed that the objective findings and associated disability for each leg were nearly identical, and that the respective ratings should therefore be the same.  There was no evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There likewise was no limitation of motion which attained a 10% rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  With no additional functional limitation documented in the STR, the panel concluded there was not sufficient evidence to support a rating higher than 0% for either shin splint condition.  However, this provided no benefit to the CI for rating.  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 splint 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 20170223, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180010344, 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