RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX		CASE: PD-2017-05409 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20080929

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Basic Marine, medically separated for “left tibia fracture” with a disability rating of 10%.

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 - 20080807	VARD - 20091023	
Condition	Code	Rating	Condition	Code	Rating	Exam	

Left Tibia Fracture	
5265	
10%	Residuals of Midshaft Left
Tibia/Fibula Fracture Status Post ORIF with Intramedulary Tibial Rod	5262	0%	20090619	
			Right Patellofemoral Pain Syndrome	5014-5260	10%	20090929	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Left Tibia Fracture. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent intramedullary nailing of the left tibia in June 2008 after a combative training injury. At the 29 July 2008 MEB NARSUM examination, 2 months prior to separation, he was noted to be “doing well and ambulating with 50% weight bearing and showing good healing of his fracture.” On examination, the left knee range of motion (ROM) revealed flexion to 110 degrees (normal 140) and extension to 0 degrees (normal 0), without pain. An X- ray showed a healing midshaft tibia fracture with intramedullary hardware in place.

At the 19 June 2009 VA Compensation and Pension (C&P) examination, 9 months after separation, the CI reported persistent pain which had progressively worsened since onset. The examiner noted an antalgic gait but no abnormal weight bearing. There was peripatellar tenderness and crepitus, with pain at rest, but no left knee instability. After repetition, ROM was

from 0-115 degrees, with painful motion. The examiner diagnosed mild left knee chondromalacia patella/patellofemoral syndrome. At the 29 September 2009 VA C&P joint examination, 12 months after separation, the examiner noted an antalgic gait and left knee ROM from 0-140, with painful motion. After repetition, there was no additional limitation due to painful motion, fatigue, weakness or incoordination.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left tibia condition 10%, coded “5265” (likely code 5262 for tibia and fibula, impairment of), and listed “status post-surgical fixation” as a Category II condition (contributes to the primary unfitting condition but not separately ratable). Panel members agreed that this related diagnosis was properly subsumed under the overall rating for the left tibia fracture IAW
§4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The VA rated the left tibia condition 0%, coded 5262, based on the C&P examination, citing no of malunion of the tibia and fibula with slight knee or ankle disability. The panel adjudged that there was no evidence of a moderate knee disability to support a higher 20% rating under code 5262, and upon consideration of other VASRD knee and analogous codes, all were less applicable and/or not advantageous for rating. There was therefore no higher rating than the 10% adjudicated by the PEB. Panel members discussed correcting the code to 5262, as noted on the Joint Disability Evaluation Tracking System notes in evidence, but this provided no benefit to the CI. 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.

2	PD-2017-05409

DEPARTMENT OF THE NAVY
SECRETARY OF TIIB NAVY COUNCIL OF REVIEW BOARDS 720 KENUON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO,
1850
CORB: 003
10 Sep 20

From: Director, Secretary of the Navy Council of Review Boards To:	XXXXXXXXXXXXXX

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.