RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-05015
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20090625

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E7, Communications-Computer Systems Operator, medically separated for “right tibia/fibula fracture” with a disability rating of 10%.     

CI CONTENTION:  Review requested of the fibula/tibia condition as well as an additional condition (tinnitus) not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20081203	VARD - 20091103	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Tibia/Fibula Fracture	5299-5262	10%	Residuals of Right Leg Fracture: Surgical Scars	5299-5262	10%	20071019	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Right Tibia/Fibula Fracture.  According to the service treatment record and MEB narrative summary (NARSUM), the CI sustained fractures to the right tibia and fibula on 21 September 2006 while performing field exercises, and underwent open reduction and internal fixation the next day.  At the orthopedic evaluation on 14 February 2008, the fibula was not completely fused in some areas, and the CI continued to have pain.

At the 19 October 2007 VA Compensation and Pension (C&P) examination, 20 months prior to separation, the CI reported constant, aching, sharp pain, rated at 3/10, and aggravated by physical activity.  Physical examination showed a normal gait and right knee range of motion (ROM) from 0-140 degrees (normal), with painful motion.  Examination of the ankles was “completely normal,” with dorsiflexion of 20 degrees (normal) and plantar flexion of 45 degrees (normal). There was pain after repetitive use, but it did not additionally limit the motion.  

The 3 June 2008 MEB NARSUM examination, 13 months prior to separation, noted complaints of continued daily leg pain and lower knee weakness and numbness.  The CI reported right ankle swelling which worsened after prolonged standing.  Physical examination showed lower right leg and ankle swelling and a palpable bony mass on the medial edge of the leg.  Gait was normal.  At the 3 July 2008 physical therapy evaluation for the MEB, 12 months before separation, the examiner noted “no significant functional limitations” other than pain during “timed running for military.” Right knee ROM showed full flexion and extension; right ankle dorsiflexion was to 8 degrees and plantar flexion to 20 degrees, after repetition.  
	
The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right leg condition 10%, analogously coded 5299-5262 (impairment of tibia and fibula), citing mild knee or ankle disability.  The VA also rated the right leg condition 10%, coded 5299-5262, based on the C&P examination, citing slight knee or ankle disability.  Members agreed there was no evidence of moderate disability to support a 20% rating under code 5262.  Additionally, there was no limitation of flexion or extension (5260, 5261), and no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258) to support a rating under these respective codes.  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 right leg condition.  

BOARD FINDINGS:  In the matter of the right tibia/fibula fracture 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.    

			

XXXXXXXXXX
XXXXXXXXXX 
XXXXXXXXXX

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05015.

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,