RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04321
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051209

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Information Systems Operations Analyst, medically separated for “chronic bilateral lower leg pains” with a disability rating of 0%.

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 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 - 20051017	VARD - 20060915	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Lower Leg Pains	5022	0%	Right Tibial Stress Strain and Knee Strain	5260	0%	20060520	
			Left Tibial Stress Strain and Knee Strain	5261	0%		
Adjustment Disorder with Depressed and anxious Mood	Not Unfitting	Adjustment Disorder with Depressed Mood	9434-9440	NSC	20060609	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Bilateral Lower Leg Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s bilateral shin pain began in April 2002, within 1 month of starting Army physical training, and she was treated with crutches and temporary profiles and physical therapy over 3 years.  During the July 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the examiner documented bilateral lower extremity tenderness, greater on the left than right, but no signs of inflammation.  The 12 August 2005 MEB NARSUM examination, 4 months before separation, noted CI complaints of constant bilateral shin pain, rated at 8/10, and worsened by standing more than 5 minutes, climbing more than two flights of stairs, and running or jumping.  Physical examination revealed bilateral tenderness over the anterior tibias, greatest at the midpoints and worse on the left.  There was no redness or swelling, and muscle strength was 5/5, with sensation intact bilaterally.  There was normal knee and ankle joint range of motion (ROM), and X-rays were normal.  Bone scans demonstrated findings consistent with minimal stress-related changes.

At the 20 May 2006 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported constant shin pain and could not take medication due to being pregnant.  The examiner noted normal gait and weight bearing and that the CI wore 2-inch platform heels and had bilateral shin pain with bending and squatting.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral lower leg condition 0%, coded 5022 (periostitis), citing full motion and strength of all lower extremity joints.  The VA separately rated the right and left tibial/knee conditions 0% each, coded 5260 (leg, limitation of flexion of), based on the C&P examination, citing the absence of objective evidence findings to warrant a higher evaluation.  Panel members first considered the evidence for the left leg condition, and agreed that although the NARSUM indicated tenderness to palpitation and the C&P examination noted bilateral shin pain with squatting and bending, a 0% rating was justified since there was no evidence of limitation of motion, abnormal X-ray/bone scan findings, or weakness/sensation loss.  The panel next considered the right leg condition, and also adjudged that there was no NARSUM or C&P findings to support a rating higher than 0%.  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 leg condition.  

Contended PEB Condition:  Adjustment Disorder with Depressed and anxious Mood.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement, and did not fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the bilateral lower leg condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended adjustment disorder, the panel recommends no change from the PEB determination as not unfitting.  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:

AR20200002313 

Dear XXXXXXXXXXXX:

	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.