RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201149 SEPARATION DATE: 20021106 

BOARD DATE: 20130314 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty PFC/E-3 (63W/Wheel Vehicle Repairer) medically 
separated for bilateral leg pain. He developed the pain in 2001 after running, and was 
subsequently diagnosed with chronic bilateral tibial stress fractures. The conditions did not 
respond adequately to treatment 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 condition (as a bilateral 
diagnosis) was forwarded to the Physical Evaluation Board (PEB) as medically unacceptable IAW 
AR 40-501. No other conditions were submitted by the MEB. The PEB adjudicated “chronic leg 
pain due to bilateral tibial stress fractures” as unfitting, rated 10%, citing criteria of the US Army 
Physical Disability Agency (USAPDA) pain policy. The CI made no appeals, and was medically 
separated with that disability rating. 

 

 

CI CONTENTION: “I believe that my condition has worsened and should be rated higher. My 
pain has increased and its [sic] getting more and more difficult to walk or stand for prolonged 
periods of time.” 

 

 

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 leg condition(s) is 
addressed below; and, no additional conditions are within the DoDI 6040.44 defined purview of 
the Board. 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 respective 
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 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, 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 20020816 

VA (8 Mo. Pre-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Bilateral Tibial Stress Fractures 

5099-5003 

10% 

Bilateral Tibia Stress Reactions 

5021 

10% 

20020319 

Combined: 10% 

Combined: 10% 



Derived from VA Rating Decision (VARD) dated 20021112 (most proximate to date of separation [DOS]). 

 

 

ANALYSIS SUMMARY: 

 

Bilateral Tibial Stress Fracture Condition. The first treatment note for the condition was May 
2001 noting bilateral lower leg pain (right > left). Later notes document a diagnosis of shin 
splints, aggravated by prolonged weight bearing activities. This was managed with anti-
inflammatory medications and temporary profile. Bone scans confirmed a diagnosis of bilateral 
tibial stress fractures, the orthopedic consultant recommended weight reduction and continued 
conservative management. The CI’s pain persisted, and a MEB was initiated. The permanent L3 
profile specified “chronic bilateral leg pain.” The narrative summary (NARSUM) noted pain 
rated 8/10, precipitated by walking greater than 50 feet and aggravated by lifting. The physical 
exam noted bilateral pre-tibial tenderness and nodularity, with no positive knee or ankle 
findings. The VA prior to separation VA Compensation and Pension (C&P) evaluation was 
performed the same day as the NARSUM exam. Similar pain characteristics and physical 
limitations were documented. Physical findings were also equivalent, and a normal gait was 
documented. The commander’s statement did not specify the diagnosis, but noted similar 
physical limitations; and, noted that the CI was flagged for being “62 pounds over his allowable 
weight.” 

 

The Board directs attention to its rating recommendations based on the above evidence. IAW 
VASRD §4.7 (higher of two evaluations), the Board must consider separate ratings for PEB 
bilateral orthopedic adjudications; although, separate fitness assessments must justify each 
disability rating. In this case, there was no evidence separating the clinical features or 
attendant disability for either lower extremity. Members agreed that there was no 
performance based criteria in evidence which would support a conclusion that either extremity, 
in isolation, was reasonably justified as separately unfitting; and, therefore, the PEB’s fitness 
determination was likely grounded in the principle of overall effect. Furthermore, the bilateral 
diagnosis supported a single 5003 rating for “2 or more major joints” (as also applied by the 
VA); and, IAW VASRD §4.71a, no specific joint or extremity code is applicable outside 5003 
based rating. Members thus agreed that separate disability ratings for right and left leg 
conditions could not be supported. 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 of the bilateral tibial stress fracture 
condition. 

 

 

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 bilateral tibial stress fractures was operant in this 
case and it was adjudicated independently of that policy by the Board. In the matter of the 
bilateral tibial stress fracture condition and IAW VASRD §4.71a, 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 and separation determination, as follows: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Chronic Leg Pain Secondary to Bilateral Tibial Stress Fractures 

5099-5003 

10% 

COMBINED (w/ BLF) 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120612 w/atchs. 

Exhibit B. Service Treatment Record. 

Exhibit C. Department of Veterans’ Affairs Treatment Record. 

 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxxxxxx, AR20130006160 (PD201201149) 

 

 

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)