RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-05724
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20061020

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Nuclear Medicine Craftsman, medically separated for “right compartment syndrome status post fasciotomy for decompression” with a disability rating of 20%.

CI CONTENTION:  No specific contention was made.  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 – 20060906	VARD – 20080314	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Compartment Syndrome… 	5311	20%	Status Post Fasciotomy for Compartment Syndrome Decompression 	5311	10%	20070716	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:   30%	

ANALYSIS SUMMARY:  

Right Compartment Syndrome.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was diagnosed with tri-compartment syndrome in October 2005 and underwent a right lower leg fasciotomy in January 2006.  Post-operative rehabilitation improved his condition to the point of residual numbness in the right leg.  The 10 July 2006 MEB NARSUM examination, 3 months prior to separation, noted complaints of persistent right leg numbness and weakness.  Physical examination revealed that the CI walked with a cane, but other findings were limited in focus and only noted mild (4/5) right lower leg and ankle weakness. 

At the 16 July 2007 VA Compensation and Pension (C&P) examination, 9 months after separation, the CI endorsed pain on the inside aspect of the right ankle which occurred 3 times per week and lasted an hour each episode. The pain occurred spontaneously and was relieved ‘by time and rubbing,’ with no need for medication to function.  The CI stated that his condition did not cause incapacitation, and current treatment included stretching and physical therapy.  The examiner noted a normal gait with no use of an assistive device, and no weakness, swelling, heat, redness, locking or dislocation.  However, there was right lower extremity peripheral nerve involvement with findings of neuralgia and slightly decreased sensation below the knee and 5-/5 strength. 

The panel directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA rated the right leg condition 20%, coded 5311 (Group XI muscle), citing VASRD guidelines and “moderate” muscle disability.  While the CI’s condition is not specifically listed in the VASRD rating schedule, the PEB’s coding approach and rating remained consistent with the  clinical history and §4.73 standards.  The VASRD schedule of ratings for Group XI muscle injuries has a total of four rating levels spanning from 0% to 30% impairment.  Panel members agreed that the documented motor and sensory loss of the right lower extremity was of a slight to moderate degree, and thus would rate no greater than a 10% (moderate) rating.  However, IAW DoDI 6040.44, the panel may not recommend a rating lower than that received prior to application.  The panel considered other VASRD nerve and analogous codes, but all were less applicable and/or not advantageous for rating.  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’s adjudication for the right leg condition. 

BOARD FINDINGS:  In the matter of the right leg condition and IAW VASRD §4.73, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel recommends no modification or re-characterization of the CI’s disability and separation determination.

SAF/MRB

Dear XXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05724.

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 rating modification or re-characterization 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 modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.