RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03225
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070623

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Security Forces Helper, medically separated for “stress fracture proximal left tibia” with a disability rating of 10%. 

CI CONTENTION:  “Having some issues with my feet and legs that may be related to military constant pain.”  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 - 200705	VARD - 20080220	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Stress Fracture Proximal Left Tibia	5262	10%	Left Tibia Stress Fracture, Healing	5299-5262	10%	20071108	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Stress Fracture Proximal Left Tibia.  According to the service treatment record and MEB summary (NARSUM), the CI initially sought treatment on 5 January 2007 with complaints of knee and leg pain, and she was placed on medical hold prior to completing her specialty training.  On 19 January 2007, X-rays revealed a stress fracture of the proximal left tibia. Due to an extended rehabilitation period (6-12 months), she could not return to training and was referred for MEB.  

The 4 April 2007 MEB NARSUM examination, 2 months prior to separation, noted complaints of persistent, bilateral leg pain.  Physical examination showed a normal gait, tenderness of both tibial shafts (shins), and normal range of motion (ROM) of both knees and ankles.  

At the 8 and 10 November 2007 VA Compensation and Pension (C&P) evaluations, 5 months after separation, the CI reported bilateral shin and knee pain.  She worked as a waitress and noted increased left shin pain as her shift progressed.  Physical examination revealed a normal gait with no walking limitations or abnormal shoe wear.  There was bilateral shin tenderness, but knee range of motion (ROM) was full and pain-free.  A left leg X-ray was normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left proximal tibia stress fracture condition 10%, coded 5262 (impairment of the tibia and fibula).  The VA also rated the left tibia stress fracture condition 10%, coded analogously as 5262, based on the C&P evaluation, citing tenderness over the anterior border of the left tibia.  Members noted that while the evidence showed persistent left shin tenderness, the NARSUM and VA examinations were otherwise relatively unremarkable.  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 left tibia stress fracture condition.  

BOARD FINDINGS:  In the matter of the left tibia stress fracture 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 20170509, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-03225.

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