RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03112
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20090313

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Pavements & Construction Equipment Journeyman, medically separated for “chronic right lower leg pain…with overlying tender scar” with a disability rating of 20%.   

CI CONTENTION:  “Review all conditions.”  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 – 20081118	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Low Leg Pain…with Overlying Tender Scar	7801	20%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Right Lower Leg Pain…with Overlying Tender Scar.  According to the service treatment record and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent right leg surgery in May 2007 for open tibia and fibula fracture after a motorcycle accident.  The 6 May 2008 physical therapy range of motion (ROM) examination, 10 months prior to separation, showed 10 degrees of right ankle dorsiflexion (normal 20) and 35 degrees of plantar flexion (normal 45).  Right knee flexion was 135 degrees (normal 140) and there was 2 degrees of right knee (hyper) extension (normal 0).  

The 23 September 2008 MEB NARSUM examination, 6 months prior to separation, noted complaints of persistent right leg pain with exacerbations of severe pain and swelling.  Physical examination showed a tender healing wound on the right lower leg.  Gait and stance were normal.  The examiner concluded the CI continued to have chronic pain and swelling related to the soft tissue injury.  The CI was not expected to make significant improvement with therapy or hardware removal.  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right lower extremity scar 20%, coded 7801 (burn scar or scar due to other causes, not of the head, face, or neck, that are deep and nonlinear), citing tender scar.  The panel noted the PEB rated the right lower extremity condition as a deep and nonlinear scar.  However, there was no description of the scar size within the record upon which to base a rating.  The panel considered rating the condition for ankle limitation of motion, but the limitation did not support a rating higher than 10% under the diagnostic code for ankle limitation of motion (5271).  Because there was no ankylosis, nonunion, or malunion, VASRD §4.71a offers no applicable joint code which would yield higher than a 20% rating.  The panel also considered whether rating under the VASRD code for other foot injuries (5284) provided for a higher rating (§4.7), however all panel members agreed that the “severe” level (30%) was not supported.  The panel agreed there was no knee limitation of motion that supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  There was no evidence of recurrent subluxation or lateral instability for an additional rating of 10% coded 5257.  There was no fracture, nonunion, or malunion of the tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5262).  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 right lower extremity condition.  

BOARD FINDINGS:  In the matter of the right lower leg condition and IAW VASRD §4.118, 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 20170327, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-03112.

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.

						Sincerely,

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings