DEPARTMENT  OF  THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374

IN   REPLY   REFER  TO:
1850
CORB:003
20 Feb 20

From: To:

Director, Secretary of the Navy Council of Review Boards 
PD-2017-02958

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 13 Mar 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy.

2.	On 12 February 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02958 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20080929

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty O3, Field Artillery Officer, medically separated for “status post (S/P) delayed fasciotomy for compartment syndrome with significant muscle loss and requirement for serial debridement, delayed primary closure and eventual tendon transfers, with a disability rating of 20%.

CI CONTENTION: Review of all conditions requested. 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 - 20080617	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Lower Extremity Pain	5312	20%	No VA Examination Proximate to  Separation in Evidence	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: NA	
	
ANALYSIS SUMMARY:

Right Lower Extremity (RLE) Pain. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent surgeries in 2004 and 2005 for fasciotomy for compartment syndrome with significant muscle loss and requirement for serial debridement, delayed primary closure, and tendon transfer. He returned to full duty but was unable to pass a physical fitness test (PFT) and continued to have debilitating right extremity pain. The CI stated he was able to do all other functions of his military occupational (MOS) other than physical training.   He had exhausted all available non-operative measures.   Tibia and fibula X-rays on   10 April 2008 showed no fracture and normal mineralization. Physical examination on the same

day showed generalized weakness to all motor groups. Strength was 3/5 in the lower muscle groups. One tendon (extensor halluces longus) had some scarring and was non-mobile. Sensation was grossly diminished in the superficial and deep peroneal and tibia nerve distribution. Ankle mobility was slightly decreased and he had plantar flexion to about 30 degrees (normal 45) and dorsiflexion to about 5 degrees (normal 20). The 30 April 2008 MEB NARSUM examination, 5 months prior to separation, noted complaints of right leg easy fatigue and recent increased difficulty with his RLE stamina and increasing pain. He was unable to perform the PFT run since his injury and surgeries. The examiner noted the CI had significant muscle loss and requirement for serial debridement, delayed primary closure and eventual tendon transfers. The examination corroborated that the RLE was grossly diminished in function.

During the 6 May 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI reported slight numbness on the bottom of the right foot, impaired use of right leg/foot, and drop foot of the right leg. Physical examination revealed 3/5 strength in both plantar and dorsiflexion of the right ankle, and 3/5 strength with flexion and extension of the toes. There was decreased sensation to light touch over the right leg and foot. The examination noted right foot drop. The 21 May 2008 non-medical assessment noted the CI was still working in his MOS and had not missed any work or duty due to his medical condition. He continued to train and conduct physical training with limits prescribed but could not maintain a moderate level of running.  No VA examination proximate to separation was in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the RLE condition 20%, coded 5312 (Group XII: function, moderately severe.) The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the RLE compartment syndrome 20% respectively, coded 5312 (Group XII muscle injury, slight), citing a moderate level of impairment. Panel members agreed there was evidence of a moderately severe level of impairment with loss of strength, weakness, fatigue, muscle, sensation, and pain ultimately resulting in right foot drop. However, although he was not able to maintain a moderate level of running the CI was able to work in his MOS and had not lost time from work due to his condition. After due deliberation, considering all 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 RLE pain.

BOARD FINDINGS: In the matter of the S/P delayed fasciotomy for compartment syndrome with significant muscle loss and requirement for serial debridement, delayed primary closure and eventual tendon transfers 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.

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170330, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record	

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