RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:XXXXXXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-05944
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20070716

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Dental Technician, medically separated for “right lower extremity pain of unclear etiology” with a disability rating of 10%.

CI CONTENTION: “I was separated for a very nondescript condition regarding my eight year history of unresolved leg pain.” The CI also requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and/or 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 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:

20070511	VARD - 20070822	
Condition	Code	Rating	Condition	Code	Rating	Exam	

Right Lower Extremity Pain of Unclear Etiology	
5399-5313-8722	
10%	S/P Fasciotomies of Anterior. Lateral and Posterior Compartments, Mid-Third of Right Leg Secondary to Compartment	
8699-8622	
10%	
20070629	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Right Lower Extremity Pain of Unclear Etiology. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI had a prolonged history of right leg pain that was aggravated with prolonged standing and especially with running. After an extensive evaluation the diagnosis of chronic compartment syndrome was considered and therefore, on 7 June 2006, the CI underwent a 4-compartment fasciotomy on the right lower leg. Despite extensive rehabilitation the CI’s right leg pain remained.

The 23 March 2007 MEB NARSUM examination, 4 months prior to separation, noted complaints of continued right leg pain with numbness that extended from the mid-aspect of the right leg

into her right foot. The physical examination (PE) revealed tenderness and decreased sensation over the outer aspect of the right lower leg. Strength and range of motion of the right leg was normal.

At the 29 June 2007 VA Compensation and Pension (C&P) examination, 1 month prior to separation, the CI reported increased swelling in the lower right leg when sitting for a prolonged period. She additionally endorsed the inability to wear heavy military boots due to the upper portion of the boot causing pressure on her leg. A detailed PE of her right lower extremity was completely normal. Her diagnosis remained unchanged and the examiner documented the following: “Currently, the [CI] has minor disability related to [her condition] with increased symptoms and associated limitation with simple activities of sitting or extended walking. However, she apparently has not had significant disability so as to restrict her occupational activities. It would appear that there is slight functional impairment related to these activities on the basis of pain that she experiences without obvious indication of structural abnormality. There is no indication of instability or incoordination. Weakness, fatigability and lack of endurance would appear to be minor secondary factors of her impairment.”

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right leg condition 10%, analogously coded 5399-5312-8722 (muscle group XIII - neuralgia). The VA also rated the right leg condition 10%, analogously coded 8699-8622 (neuritis), based on the C&P examination, citing a minor disability with increased symptoms and associated limitation with simple activities of sitting or extended walking activities, and slight functional impairment based on pain. Later, a DRO decision on 19 September 2008 increased the service connected disability to 20%, effective from 17 July 2007.

While the CI’s considered condition of chronic compartment syndrome thus resulting in surgical intervention is not specifically listed in the VASRD rating schedule, both the PEB’s and VA’s analogous primary coding approaches were appropriate for rendering an impairment rating having both muscular tenderness and sensory (neuro) deficit near the time of separation. However, the normalization of all adverse physical findings nearest to separation, as documented at the VA examination, 1 month prior to separation, lent the greatest support for a 0% rating level. IAW DoDI 6040.44, the panel may not recommend a rating lower than that received prior to application. Therefore, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB’s adjudication for the chronic right lower extremity pain condition.

BOARD FINDINGS: In the matter of the right lower extremity condition and IAW VASRD §4.73 and §4.124a, 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:

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON 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:	

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.