RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX CASE: PD1200552 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130507 

SEPARATION DATE: 20020706 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (88M/Motor Transport Operator) medically 
separated for a right leg condition. He began to experience leg pain with running in basic 
training (1993); was subsequently diagnosed with exertional compartment syndrome 
(pathologic muscle swelling within confined fascial compartments); and, underwent a bilateral 
fascial release in 1995. He suffered persistent symptoms in his right leg which did not 
adequately improve with treatment to satisfy the demands of his Military Occupational 
Specialty (MOS) or meet physical fitness standards. He was issued a permanent L3 profile and 
referred for a Medical Evaluation Board (MEB). The right leg condition was forwarded to the 
Physical Evaluation Board (PEB) IAW AR 40-501, and no other conditions were submitted by the 
MEB. The PEB adjudicated the right leg condition (specifying surgical residuals) as unfitting, 
rated 0%, citing criteria of the US Army Physical Disability Agency (USAPDA) pain policy. The CI 
made no appeals, and was medically separated with a 0% Service disability rating. 

 

 

CI CONTENTION: “I still have pain in my legs when standing or driving for a long period of time. 
Recently did not get a job because it called for driving for a period of time. I feel I cannot 
perform when it comes to my job. I constantly have to sit or lean on something to releave the 
pain. I feel that this operation I had while in the military will hinder me for life. A review of my 
case will be greatly appreciated.” 

 

 

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, 
paragraph 5.e. (2). It is limited to those conditions determined by the PEB to be unfitting for 
continued military service and those conditions identified but not determined to be unfitting by 
the PEB when specifically requested by the CI. The rating for the unfitting right leg condition is 
addressed below. The contention implies that ratings for both legs are desired, but the left leg 
condition was not identified by the PEB; and, thus is not within the DoDI 6040.44 defined 
purview of the Board. That, and any other conditions or contention not requested in this 
application, remain eligible for future consideration by the Service Board for Correction of 
Military Records. The Board acknowledges the CI’s information regarding the significant 
impairment with which his service-connected condition continues to burden him; but, must 
emphasize that the Disability Evaluation System (DES) has neither the role nor the authority to 
compensate members for anticipated future severity or potential complications of conditions 
resulting in medical separation. That role and authority is granted by Congress to the 
Department of Veterans Affairs (DVA), operating under a different set of laws. Post-separation 
evidence is probative to the Board’s recommendations only to the extent that it reasonably 
reflects the disability at the time of separation. 

 

 

 


RATING COMPARISON: 

 

Service IPEB – Dated 20020409 

VA (4+Yrs. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Pain Residuals, Fascial 
Release, Right Lower Leg 

5099-
5003 

0% 

S/P Fasciotomy, Right Lower Extremity 

5314 

10% 

20061120 

No Additional MEB/PEB Entries 

S/P Fasciotomy, Left Lower Extremity 

5314 

10% 

20061120 

Combined: 0% 

Combined: 20% 



Derived from VA Rating Decision (VARD) dated 20070116(most proximate to date of separation [DOS]). 

 

 

ANALYSIS SUMMARY: The Board notes the significant interval (greater than 4 years) between 
the date of separation and the earliest VA evaluation. DoDI 6040.44 provides for consideration 
of post-separation VA findings, particularly within 12 months of separation; although, the 
Board’s recommendation is premised on the ratable disability present at the time of separation 
IAW the Veterans Affairs Schedule for Rating Disabilities (VASRD). Only the VA evidence which 
can be reasonably extrapolated to the date of separation is significantly probative to the 
Board’s recommendations. The information in the record was accordingly assigned the 
predominant probative value with respect to the Board’s recommendations; although, the 
delayed VA evidence was helpful in firming a conclusion that the functional disability and 
ratable findings were stable at separation. 

 

Right Leg Condition. The earliest entry in the service treatment record (STR) for lower 
extremity complaints is the June 1994 visit for right shin pain, physically associated with a 
tender “bump on the right leg calf muscle.” In retrospect this is likely attributable to the 
developing exertional compartment syndrome. It is clear from the STR that the symptoms 
developed into a bilateral complaint precipitated by running and other more strenuous 
activities; and, bilateral lower anterior fascial defects were documented, leading up to bilateral 
compartment fasciotomies in March 1995. It is incidentally noted that the CI’s contention 
appears to suggest that the disability is a result of surgical complications; but, it should be 
noted that the surgery was indicated (both for limiting symptoms and for avoiding permanent 
muscle damage), and that no surgical complications or untoward outcome is in evidence. 
Although there are several STR entries for continued exertional bilateral pain following surgery, 
there are some for right leg pain only (none for left only); and, the final orthopedic entry (7 
months pre-separation) noted that the left leg was improved, but that there were persistent 
right leg symptoms. The narrative summary (NARSUM) notes a chief complaint of, “My right 
leg hurts me when I do a lot of physical activity or to drive a truck.” The examiner confirmed 
“continues to have pain and swelling over his right leg ... when he drives a truck for an 
extended period ... [and] ... while performing physical activities with Army standards.” The 
NARSUM physical exam is excerpted below (normal gait documented in contemporary STR 
entries). 

The right leg demonstrates a 10 x 5-cm fascial defect with a palpable defect over the right 
anterolateral aspect of his leg. He is mildly tender with palpation as well as with resisted 
dorsiflexion and planter-flexion. He is neurovascularly intact distally and proximally with a full 
range of motion on his right lower extremity. 

At the significantly delayed VA Compensation and Pension (C&P) evaluation, the CI reported 
bilateral symptoms with no distinction of severity between right and left. He was fully 
employed with a satellite TV contractor. The examiner recorded bilateral lower extremity pain 
with “driving or walking or running;” and, physical findings noted a “slightly indented scar” on 
the right and a “slightly visible scar” on the left, with normal bilateral range-of-motion (ROM) 
and gait. 

 

The Board directs attention to its rating recommendation based on the above evidence. All 
members agreed that the PEB’s coding designation as analogous to 5003 (degenerative 


arthritis) could be challenged on the basis of VASRD §4.7 (higher of two evaluations). The 
pathology in this case definitively supports a rating for muscle disability as subsequently applied 
by the VA, and which would be favorable to rating. Furthermore the PEB’s 0% rating, as 
supported by the USAPDA pain policy, arguably conflicts with VASRD §4.40 (functional loss) 
which would support a rating of 10%. With regard to rating under a muscle disability code, it is 
noted that the VA code is not anatomically consistent with the pathology. The code 5314 is for 
Group XIV, thigh flexors. The affected muscle group in this case was Group XII, lower leg 
extensors, which carries the code 5312. It yields ratings based on ‘slight’, ‘moderate’, 
‘moderately severe’, and ‘severe’ muscle disability; rated 0%, 10%, 20%, and 30%. Intrinsic to 
muscle disability rating descriptions is the presence of cardinal signs and symptoms, defined in 
VASRD §4.56 as “loss of power, weakness, lowered threshold of fatigue, fatigue-pain, 
impairment of coordination and uncertainty of movement.” Of these, the evidence indicates 
that ‘lowered threshold of fatigue’ and ‘fatigue-pain’ were present. The ‘slight’ (0%) rating is 
for “healing with good functional results” and “no cardinal signs or symptoms.” The ‘moderate’ 
(10%) rating description is “Record of consistent complaint of one or more of the cardinal signs 
and symptoms ..., particularly lowered threshold of fatigue after average use, affecting the 
particular functions controlled by the injured muscles.” The ‘moderately severe’ (20%) rating 
description is “Record of consistent complaint of one or more of the cardinal signs and 
symptoms ... and, if present, evidence of inability to keep up with work requirements.” The 
‘severe’ rating (30%) requires cardinal signs and symptoms “worse than those shown for 
moderately severe only 2 muscle injuries;” and, introduces a list of associated physical findings, 
none of which were in evidence. Deliberations settled on arguments for a ‘moderate’ 10% 
recommendation vs. a ‘moderately severe’ 20% recommendation. Members agreed that the 
‘moderate’ rating description was a good match for the disability in evidence at separation; 
and, that, even though there was an inability to keep up with MOS and military specific work 
requirements, this did not reasonably translate into civilian occupational barriers. It is also 
noted that the VA rating, albeit under the wrong code, was for ‘moderate’ muscle disability. 

 

 

BOARD FINDINGS: IAW DoDI 6040.44, provisions of DoD or Military Department regulations or 
guidelines relied upon by the PEB will not be considered by the Board to the extent they were 
inconsistent with the VASRD in effect at the time of the adjudication. As discussed above, PEB 
reliance on the USAPDA pain policy for rating the right leg condition was operant in this case 
and the condition was adjudicated independently of that policy by the Board. In the matter of 
the right leg condition, the Board unanimously recommends a disability rating of 10%, coded 
5312 IAW VASRD §4.56. There were no other conditions within the Board’s scope of review for 
consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of his prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Residuals of Fasciotomy, Right Lower Extremity 

5312 

10% 

COMBINED 

10% 



 

 

 


The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120605, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxxxxxx, AR20130011105 (PD201200552) 

 

 

1. I have reviewed the enclosed Department of Defense Physical Disability Board of Review 
(DoD PDBR) recommendation and record of proceedings pertaining to the subject individual. 
Under the authority of Title 10, United States Code, section 1554a, I accept the Board’s 
recommendation to modify the individual’s disability rating to 10% without recharacterization 
of the individual’s separation. This decision is final. 

 

2. I direct that all the Department of the Army records of the individual concerned be corrected 
accordingly no later than 120 days from the date of this memorandum. 

 

3. I request that a copy of the corrections and any related correspondence be provided to the 
individual concerned, counsel (if any), any Members of Congress who have shown interest, and 
to the Army Review Boards Agency with a copy of this memorandum without enclosures. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)