RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201175 SEPARATION DATE: 20020805 

BOARD DATE: 20130301 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was a National Guard PV2/E-2 (12C/Basic Trainee), medically separated 
for bilateral tibial plateau stress fractures. The CI had bilateral knee pain since the fifth week of 
basic training. She was treated with physical therapy (PT), non-steroidal anti-inflammatory 
drugs (NSAIDs), convalescent leave for 30 days, and modification of activities. Despite 
treatment, she continued to have severe pain, exacerbated by running, jumping, push-ups, 
prolonged standing, marching, and strenuous activities. Clinical examinations, a bone scan and 
X-rays were consistent with non-displaced bilateral tibial plateau fractures. She did not 
improve adequately to meet the physical requirements of her Military Occupational Specialty 
(MOS) or satisfy physical fitness standards. She was issued a permanent L3 profile and referred 
for a Medical Evaluation Board (MEB), which determined that it was not medically acceptable. 
No other conditions were forwarded by the MEB to the Physical Evaluation Board (PEB). The 
PEB adjudicated the bilateral tibial plateau stress fractures condition as unfitting, rated 0%, with 
application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The CI made no 
appeals and was medically separated with a 0% disability rating. 

 

 

CI CONTENTION: “I am not able to stand for long periods of time. I experience intense pain and 
swelling in my legs. I have been to see doctors for treatment for my condition.” 

 

 

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 IPEB – Dated 20020710 

VA (>1 Mo. Post-Separation) – All Effective Date 20020806 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Bilateral Tibial Plateau 
Stress Fractures 

5099-5003 

0% 

Healed Minor Stress Fractures, 
Tibias, Fibulas, and Pelvic Area 

5014 

NSC 

20020919 

.No Additional MEB/PEB Entries. 

Combined: NSC 

Combined: 0% 



 

 

ANALYSIS SUMMARY: 

 

Bilateral Tibial Plateau Stress Fractures Condition: The CI developed bilateral knee pain during 
basic training which prevented continuation of training. She was treated conservatively and 
placed on convalescent leave for 30 days without complete resolution of symptoms. The MEB 
examiner, who dictated the narrative summary (NARSUM) 2 months prior to separation and 


was the treating orthopedist, opined that if she were to continue basic training, these fractures 
would not heal. She was issued a permanent L3 profile for bilateral tibial plateau stress 
fractures with inability to run at own pace and distance nor walk or run in pool at own pace. 
She was also unable to wear a 40 pound backpack or fire a rifle and unable to march or do sit-
ups. There was one goniometric range-of-motion (ROM) evaluation in evidence, with 
documentation of additional ratable criteria, which the Board weighed in arriving at its rating 
recommendation; as summarized in the chart below. 

 

Knee ROM 

In degrees (Normal) 

MEB ~2 Mos. Pre-Sep 

VA C&P ~1 Mo. Post-Sep 

Left 

Right 

Left 

Right 

Flexion (140 Normal) 

135 

135 

Normal 

Normal 

Extension (0) 

0 

0 

Normal 

Normal 

Comment 

FROM 

Tender proximal 
tibia 

Normal gait 

FROM 

Tender proximal 
tibia 

Normal gait 

Tender proximal 
tibia 

Normal gait 

No swelling 

Tender proximal 
tibia 

Normal gait 

No swelling 

§4.71a Rating 

0% 

0% 

0% 

0% 



 

The MEB NARSUM physical exam noted normal ROM with tender bilateral proximal tibial areas 
at the knee, normal gait, no instability, normal sensation, and normal skin. A bone scan was 
noted as showing bilateral stress fractures. X-rays showed healing stress fractures of the tibial 
plateaus bilaterally. At the VA Compensation and Pension (C&P) examination, a month after 
separation, the CI reported pain of both proximal tibial areas, and the left hip. The examination 
revealed normal knee, ankle, and hip ROM, with slight tenderness to deep palpation in the 
proximal tibia, no swelling, normal gait. X-rays were normal. The VA examiner diagnosed 
healed minor stress fractures of the tibia, fibula, and pelvic areas. The Board directs attention 
to its rating recommendation based on the above evidence. The Board considered VASRD 
diagnostic code 5099-5003 (rated analogously to degenerative arthritis) used by the PEB for a 
zero percent rating. The Board examined the evidence. There was no radiological evidence of 
arthritis and no pain on normal ROM testing to support a higher permanent disability rating. 
The VA determined the condition to be not service-connected (NSC) using the code 5014 
(osteomalacia). The Board found no evidence in the clinical record of swelling, muscle spasm, 
or painful motion to support a higher rating. The Board determined the 30 day convalescence 
leave to be therapeutic rather than evidence of an occasional incapacitating exacerbation. The 
Board also considered the code 5257 (other impairment of knee) and found no evidence of 
recurrent subluxation or lateral instability in the clinical record for a rating under this code. 
Finally, it reviewed the code 5262 (impairment of tibia and fibula) and found no evidence of 
nonunion, loose motion, or a requirement of a brace, to support a higher rating. 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 tibial plateau stress fractures 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. 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 tibial plateau stress fractures 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 

Bilateral Tibial Plateau Stress Fractures 

5099-5003 

0% 

COMBINED 

0% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120615, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxx, AR20130007624 (PD201201175) 

 

 

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 xxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)