RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200731 SEPARATION DATE: 20011205 

BOARD DATE: 20130206 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty Soldier, PFC/E-3 (88M/Motor Transport Operator), 
medically separated for bilateral exercise-induced compartment syndrome. The CI began 
having aching and intermittent tingling in his lower legs and feet shortly after induction into the 
Army. Despite two exercise-induced compartment release surgeries in each leg and physical 
therapy (PT), the CI was unable to meet the physical requirements of his Military Occupational 
Specialty (MOS) or satisfy physical fitness standards. He was issued a permanent L3 profile and 
referred for a Medical Evaluation Board (MEB). The MEB forwarded exercise-induced 
compartment syndrome and decreased sensation and weakness lateral aspect right lower 
extremity (LE), status post (s/p) exercise syndrome release as medically unacceptable IAW AR 
40-501 to the Physical Evaluation Board (PEB). The MEB forwarded no other conditions for PEB 
adjudication. The PEB adjudicated “Bilateral Exercise-Induced Compartment Syndrome with 
Surgical Releases without Alleviation of Symptoms” as unfitting, rated each LE at 10%, with 
application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The CI made no 
appeals, and he was medically separated with a combined 20% disability rating. 

 

 

CI CONTENTION: “I was discharged at 20% and was denied benefits until 2008. Had my initial 
rating been more, I may have had a better chance for coverage.” sic 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44, Enclosure 3, paragraph 5.e. (2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings 
for unfitting conditions will be reviewed in all cases. Any conditions or contention not 
requested in this application, or otherwise outside the Board’s defined scope of review, remain 
eligible for future consideration by the Army Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service PEB – Dated 20011011 

VA (12 & 13 Mos. Post-Separation) – All Effective Date 20011206 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Left Lower Extremity 
Exercise-Induced 
Compartment Syndrome 

5399-5312 

10% 

Exercise-Induced Compartment 
Syndrome, Left Lower Extremity, 
S/P Fasciotomy 

8799-8724 

0%* 

20030114 

Right Lower Extremity 
Exercise-Induced 
Compartment Syndrome 

5399-5312 

10% 

Exercise-Induced Compartment 
Syndrome, Right Lower 
Extremity, S/P Fasciotomy 

8799-8724 

0%* 

20030114 

 

.No Additional MEB/PEB Entries. 

 

Not Service-Connected x 1 

20021203 

Combined: 20% 

Combined: 0% 




*Increased to 10% each, and left shoulder adhesive capsulitis added, all effective 20080519 with new combined rating of 30% 
by VARD of 20090612. Subsequently, both were increased to 20% effective 20090821 with a new combined rating of 50%. 

 

ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed in the CI’s application 
that had the gravity of his condition merited consideration for a higher separation rating that 
he would have had a better chance at coverage for benefits. It is a fact, however, 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. This role and authority is granted by Congress to the Department of 
Veterans Affairs (DVA). The Board’s authority as defined in DoDI 6040.44, resides in evaluating 
the fairness of DES fitness determinations and rating decisions for disability at the time of 
separation. The Board utilizes DVA evidence proximal to separation in arriving at its 
recommendations; and, DoDI 6040.44 defines a 12-month interval for special consideration to 
post-separation evidence. Post-separation evidence is probative only to the extent that it 
reasonably reflects the disability and fitness implications at the time of separation. 

 

Bilateral Exercise-Induced Compartment Syndrome Condition. On the DA Form 199, the PEB 
appeared to have combined left and right exercise-induced compartment syndrome as a single 
unfitting condition, coded analogously to 5312, and rated 20%. However, the PEB rated each LE 
at 10% and the bilateral factor was applied to arrive at the combined 20% rating. There were 
two evaluations in evidence, with documentation of additional ratable criteria, which the Board 
weighed in arriving at its rating recommendation, as summarized in the chart below. 

 

Bilateral 
Lower 
Extremity 

MEB ~ 3 Mos. Pre-Separation 

VA C&P 

~13 Mos. Post-Separation 

Left 

Right 

Left 

Right 

 

Anterior scar 2 fingerbreadths 
some decreased sensation to 
light touch; everter muscles 
5/5 strength 

Some Tinel’s (lightly tapping over the 
nerve elicits a tingling sensation-nerve 
irritation) throughout scar; some 
weakness of everter muscles 4/5 strength 

Motor: strength, muscle 
tone of major muscle 
groups normal; normal 
gait; Sensory: pain, 
touch, proprioception 
intact; patellar/Achilles 
tendon reflexes 2+ 
symmetrical; plantar 
responses flexor 
bilaterally (normal) 

Stable to valgus/varus stresses, negative Lachman’s; no pivot; no effusion; 
well healed scars 15 cm long; tender to palpation (TTP); calf size 40 cm; 
symmetric; reflexes symmetric; normal sensation to light touch on dorsum 
lateral aspect and plantar aspect feet; heel-toe walk intact; good strength 
with plantar flexion/extensor hallicus longus 

§4.71a Rating 

10% 

10% 

10% 

10% 



 

The CI had the following four surgeries: 

1. 20000113 Right Leg Exercise-Induced Compartment Release 
2. 20000310 Left Leg Exercise-Induced Compartment Release 
3. 20001206 Repeat Right Leg Exercise-Induced Compartment Release 
4. 20010108 Repeat Left Leg Exercise-Induced Compartment Release 


The CI was granted an L3 Profile in July 2001 for bilateral exercise-induced compartment 
syndrome with restrictions of no running, no jumping, no climbing, no crawling, and no 
marching. The MEB narrative summary (NARSUM), completed approximately 3 months prior to 
separation, indicated that the CI had pain in his bilateral lower extremities with running and 
prolonged standing; numbness and weakness most notably on the right LE that interfered with 
activities of daily living; episodes of legs that fell asleep after standing at attention or parade 
rests after five minutes timeframe; and running limited to one quarter of a mile because the 


right leg more often than the left leg would fall asleep and slap the pavement. The NARSUM 
physical exam findings are summarized in the chart above. The VA Compensation and Pension 
(C&P) examination, completed approximately 13 months after separation, indicated that the CI 
continued to have pain and patchy tingling in both lower extremities that was made worse with 
exercise, prolonged walking and running. The C&P physical exam findings are summarized in 
the chart above. 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB coded the bilateral exercise-induced compartment syndromes 5399 analogous to 5312 
Group XII muscle group and assigned a 10% rating for each leg. The VA individually rated left 
and right LE exercise-induced compartment syndrome, s/p fasciotomy analogously to 8724 
neuralgia and initially rated as 0% for each lower extremity. After a reevaluation examination 
in January 2009, the VA increased the rating to 10% for each LE. These ratings were 
subsequently increased to 20% each after another repeat examination in October 2009. 
Throughout the orthopedic service treatment record (STR) notes, there was documentation of 
numbness on the bottom of the left foot and a positive Tinel’s sign on the right LE. Both the 
NARSUM and C&P examiners documented symptoms of numbness and weakness in both legs, 
legs falling asleep after standing at parade rest after 5 minutes, and pain with patchy tingling in 
both LEs. The PEB DA Form 199 specifically noted the right leg had” decreased sensation and 
weakness in the lateral aspect” and “there is no muscle atrophy.” The Board reviewed the 
tenants of §4.124 Neuralgia -characterized usually by a dull and intermittent pain, of typical 
distribution to identify the nerve, is to be rated on the same scale, with a maximum equal to 
moderate incomplete paralysis. The Board considered that the coding of 5399-5312 does not 
support a rating higher than 10% and determined that the VA rating schema that focused on 
neuralgia symptoms better reflected the functional impairment due to the bilateral exercise–
induced compartment syndrome condition. However, this coding scheme still results in a 
disability rating of 10% for each LE at the time of separation from service and offers no 
advantage to the CI. After due deliberation, considering all of the evidence and mindful of 
VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to 
recommend a change in the PEB adjudication for the bilateral exercise-induced compartment 
syndrome. 

 

 

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. The Board did not 
surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD 
were exercised. In the matter of the bilateral exercise-induced compartment syndrome 
condition and IAW VASRD §4.124a, the Board unanimously recommends no change in the PEB 
adjudication. There were no other conditions within the Board’s scope of review for 
consideration. 

 

 

RECOMMENDATION: The Board therefore recommends that there be no recharacterization of 
the CI’s disability rating and separation determination: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Left Lower Extremity Exercise-Induced Compartment Syndrome 

5399-5312 

10% 

Right Lower Extremity Exercise-Induced Compartment Syndrome 

5399-5312 

10% 

COMBINED (w/ BLF 1.9) 

20% 



 


The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120607, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxxxxxx, AR20130006185 (PD201200731) 

 

 

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 and hereby deny the individual’s application. 

This decision is final. The individual concerned, counsel (if any), and any Members of 
Congress who have shown interest in this application have been notified of this decision 
by mail. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)