RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE: PD-2017-04525 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060309

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Motor Transport Operator, medically separated for “left tibial pain” with a disability rating of 10%.

CI CONTENTION: “Continuous pain in leg, causing mid and lower back 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 - 20060206	VARD - 20060628	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Tibial Pain	5099-5003	10%	Residuals, Status Post Open Tibia Fracture Left Leg	5262	10%	STR	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Left Tibial Pain. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI fractured his left tibia in October 2003 and underwent intramedullary nailing. The proximal interlocking screws were removed in September 2004, but in July 2005 the tibia became symptomatic and there was an attempt to remove the nail in November 2005. However, the nail was damaged and could not be removed.

The 20 January 2006 MEB NARSUM examination, 2 months prior to separation, noted complaints of left leg pain aggravated by prolonged walking.     The CI was unable to run or jump, and could

not walk more than three quarters of a mile. Physical examination showed tenderness in the area of the fracture site near the incision with some hypersensitivity. There was full range of motion (ROM) of the knee and ankle and no evidence of instability. During MEB examination (recorded on DD Forms 2807-1 and 2808), 6 days later, the CI reported numbness and tingling on the left side of the left leg, and the examiner noted left leg quadriceps weakness and paresthesia.

At the 28 October 2006 VA Compensation and Pension (C&P) joints examination, 7 months after separation, the CI reported left mid-tibia pain and that he was able to stand for up to an hour and walk 1-3 miles. Physical examination showed moderate instability due to a probable left knee meniscus tear, and left knee range of motion was from 0-140 degrees (normal).

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left tibia condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing moderate and frequent pain IAW the US Army Physical Disability Agency pain policy. The VA also rated the left tibia condition 10%, but coded 5262 (impairment of the tibia), based on the STR, citing pain at the site of the fracture with slight knee disability. Panel members agreed there was no compensable limitation of flexion or extension (5260 or 5261); history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258); history of surgery to remove a meniscus (5259); or fracture, nonunion or malunion of the femur or tibia to support a higher rating under the respective codes for knee impairment related to long bone conditions (5255, 5262). Thus, there was no VASRD 4.71a rating higher than the 10% awarded by the PEB.  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 left tibia condition.

BOARD FINDINGS: In the matter of the left tibia 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:

PD-2017-04525
AR20190012733, XXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXXXX

	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.