RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-03060
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20051103

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Security Forces Helper, medically separated for “chronic tibial bilateral pain,” rated 10% for each leg, with a combined disability rating of 20%.  

CI CONTENTION:  “I had been given 20%.  For 9 years, without notice it was changed to 0% with no explanation.”  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 - 20050923	VARD - 20060731	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Tibial Bilateral Pain 	5022-5099	10%	Shin Splints left Lower Extremity	5262	10%	20060524	
		10%	Shin Splint Right Lower Extremity	5262	10%	20060524	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Tibial Bilateral Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s bilateral lower leg pain began in February 2005 during Basic Military Training (BMT) without specific trauma or injury, but the CI was noted to be poorly conditioned.  Diagnostic imaging showed bilateral lower leg stress reactions without stress fractures.  She was treated with inserts which provided partial relief allowing the CI to complete BMT and a portion of security forces training.  However, the pain did not fully resolve.  

The orthopedic examination on 26 August 2005 noted complaints of bilateral knee and lower extremity pain and swelling.  Bone scan studies showed increased uptake at the bilateral mid shaft tibia, as well as bilateral medial compartments of the knee, but X-rays were normal.  Physical examination showed no deformities and normal range of motion (ROM).   There was some tenderness over the medial tibial shaft as well as the medial tibial plateau bilaterally.  The neurovascular examination was normal.  During the 2 September 2005 MEB NARSUM examination, 2 months prior to separation, the CI complained of bilateral lower leg pain with running or prolonged standing or walking.  Physical examination showed 4/5 strength of the lower extremities, tenderness over the bilateral anterior tibias and pain with duck walk.  There was no edema, erythema, ecchymosis, crepitus or deformities.  

At the 24 May 2006 VA Compensation and Pension (C&P) examination, 7 months after separation, the CI reported a history of shin splints with stress fractures.  She related lower leg pain when standing, walking or running for any length of time.  On examination there was normal posture and gait.  The bilateral knees and ankles appeared normal and had full ROM with no pain on motion.  Following repetition, there was no pain, fatigue, weakness or lack of coordination found in the knee or ankle joints.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral lower extremity conditions 10% each leg, analogously coded 5022-5099 (periostitis).  The VA rated the lower leg conditions 10% each, coded 5262 (tibia and fibula, impairment), based on STR X-rays and the C&P examination, citing slight knee or ankle disability.  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 bilateral lower leg conditions.  

BOARD FINDINGS:  In the matter of the chronic tibial bilateral pain 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:

SAF/MRB

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-03060.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.