Search Decisions

Decision Text

AF | PDBR | CY2012 | PD2012 01273
Original file (PD2012 01273.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:    CASE: PD1201273
BRANCH OF SERVICE: Army  BOARD DATE: 20130416
SEPARATION DATE: 20020419


SUMMARY OF CASE: Data extracted from the available evidence of record reflect that this covered individual (CI) was an active duty PV2/E-2 (92A/Logistics Supply Specialist) medically separated for left leg pain. The CI developed symptoms in her 3rd week of basic training, including progressive pain and swelling of the leg. She was seen by orthopedics, and diagnosed with exercise-induced compartment syndrome, and elected to undergo surgical fasciotomy in October 2001. She had brief relief, however, the condition could not be adequately rehabilitated to meet the physical requirements of her Military Occupational Specialty or to satisfy physical fitness standards. She was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). The persistent left leg anterior compartment syndrome status post (s/p) fasciotomy condition, characterized as medically unacceptable, was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The PEB adjudicated left leg pain condition as unfitting, rated 0%, with application of the US Army Physical Disability Agency (USAPDA) pain policy. The CI appealed to the USAPDA which affirmed the PEB finding(s) and rating(s) with a 0% disability rating.


CI CONTENTION: “I had surgery on my L-Leg which I still have problems with such as numbness, tingling, pain (occas), swelling.” [sic]


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 left leg pain condition is addressed below; no additional conditions are within the DoDI 6040.44 defined purview of the Board. Any conditions or contentions not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Board for Correction of Military Records.


RATING COMPARISON :

Service PEB – Dated 20020129
 VA - (1 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Left Leg Pain 5099-5003 0% Left Leg Anterior Compartment Syndrome, Status Post Fasciotomy 5099-5024 0% 20020409
No Additional MEB/PEB Entries
 0% X 1
Combined: 0%
 Combined: 0%
Derived from VA Rating Decision (VA RD ) dated 200 20513 (most proximate to date of separation [ DOS ] ).

ANALYSIS SUMMARY: The Board acknowledges the CI’s information regarding the significant impairment with which her left leg condition continues to burden her; 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.
Left Leg Pain Condition. The CI first presented with left anterior leg pain, numbness, tingling, and intermittent swelling in 2001, while undergoing basic training. She apparently had a history of left leg pain with activity prior to entry into military service. The CI was diagnosed with chronic exertional compartment syndrome and referred to orthopedics, where the diagnosis was confirmed by the presence of elevated compartment pressures. The CI underwent a decompression (fasciotomy) on 1 October 2001, with transient relief of symptoms. However, her pain returned several months after the procedure, which led to additional work-up, including a bone scan, which was negative. Her activities were restricted and she was referred for an MEB. The MEB exam was performed on 4 January 2002, 2 months prior to separation. She was noted to be tender to palpation over the anterior compartment. Neurologic examination (strength, reflexes, sensation) was normal. Range-of-motion (ROM) of the ankle and knee were normal, without discomfort, and her gait was normal. The VA Compensation and Pension (C&P) exam, performed on 9 April 2002, several weeks following separation, noted that walking was painful for the CI, and that she had slightly decreased pinprick sensation in her left foot, but that no other abnormalities were present. Pulses were normal, and ankle motion and strength was normal. There were no ROM impairments or X-ray findings. A lower extremity electromyogram/nerve conduction velocity study conducted on 22 January 2003, approximately 10 months following separation, was entirely normal.

The Board directs attention to its rating recommendation based on the above evidence. The PEB coded the CI’s compartment syndrome as 5099-5003 (arthritis analog), and the VA assigned code 5099-5024 (tenosynovitis analog). Both the PEB and the VA rated the disability at 0%. The Board is charged with determining the best description of disability at the time of separation, rather than anticipating future progression of the unfitting condition. The latter is the role of the VA as discussed above. The Board gave emphasis to the MEB and C&P examinations which bracket the date of separation by weeks. IAW §4.56, evaluation of muscle disabilities, the Board considered the cardinal signs and symptoms of muscle disability which are loss of power, weakness, lowered threshold of fatigue, fatigue-pain, impairment of coordination and uncertainty of movement. The Board concluded that none of these were present at separation or at the time of the C&P exam. The Board next considered the ROM-based rating criteria delineated in the VASRD for codes 5003 and 5024, and found no indication of limited motion of the left lower extremity. Likewise, there were no radiographic joint abnormalities to support this type of a rating under code 5003. 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 left leg pain 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 the CI’s left leg pain was operant in this case and the condition was adjudicated independently of that policy/instruction by the Board. In the matter of the left leg pain 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
Left leg pain 5099-5003 0%
COMBINED
 0%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20120626, w/attachments
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record




         Physical Disability Board of Review


 SFMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD-ZB),

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for AR20130010239 (PD201201273)

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                                                 
                                                      (Army Review Boards)

CF:
( ) DoD PDBR
( ) DVA

Similar Decisions

  • AF | PDBR | CY2012 | PD-2012-00440

    Original file (PD-2012-00440.pdf) Auto-classification: Denied

    RATING COMPARISON: Service FPEB – Dated 20090417 Condition Code Left Leg Patellofemoral Pain Syndrome Right Leg Patellofemoral Pain Syndrome Left Leg Chronic Compartment Syndrome Right Leg Chronic Compartment Syndrome Mild Exercise Induced Asthma Low Back Bilateral Pes Planus Bilateral Planter Fasciitis Atypical Non‐Cardiac Chest Pain 5099‐5003 Rating 10% 5099‐5003 10% 5099‐5003 5099‐5003 0% 0% Not Unfitting Not Unfitting Not Unfitting Not Unfitting Not Unfitting VA (2 Weeks Pre‐Separation)...

  • AF | PDBR | CY2013 | PD2013 00129

    Original file (PD2013 00129.rtf) Auto-classification: Denied

    The PEB adjudicated “chronic bilateral lower extremity pain…”as unfitting and rated 10% per the US Army Physical Disability Agency (USAPDA) pain policy.The CI made no appeals and was medically separated. The Board must apply separate codes and ratings in its recommendations if compensable ratings for each condition are achieved IAW applicable VASRD sections. Examination of both right and left tibia/fibula were normal.

  • AF | PDBR | CY2011 | PD2011-00509

    Original file (PD2011-00509.docx) Auto-classification: Denied

    An IPEB dated 7 April 2008 adjudicated “bilateral lower leg pain with CS as unfitting rated 21% (including bilateral factor) with application of the DoDI 1332.39 and VASRD. The left leg examination was normal and without pain. The Board determined therefore that none of the stated conditions were subject to service disability rating.

  • AF | PDBR | CY2013 | PD-2013-01627

    Original file (PD-2013-01627.rtf) Auto-classification: Approved

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of theVeterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. The VA cited mal-union of the femur with moderate knee disability for its 20% rating.Members first agreed that measured ROMs were non-compensable and that sufficient evidence of painful motion was present to justify the...

  • AF | PDBR | CY2014 | PD-2014-01968

    Original file (PD-2014-01968.rtf) Auto-classification: Denied

    CI CONTENTION : The CI stated “please consider all conditions.” He could heel-and-toe walk with pain (which would indicate full strength of the leg muscles). The Board found no evidence for a higher rating in the CI’s favor under applicable codes including paralysis, neuritis, or neuralgia.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...

  • AF | PDBR | CY2014 | PD 2014 00103

    Original file (PD 2014 00103.rtf) Auto-classification: Denied

    The bilateral exertional compartment syndromecondition was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.The Informal PEB adjudicated “bilateral exertional compartment syndrome, status post fasciotomies, leftleg”as unfitting rated 0%, with application of the US Army Physical Disability Agency (USAPDA) pain policy.The CI made no appeals and was medically separated. The VA separately rated the left leg for residual surgical scars...

  • AF | PDBR | CY2009 | Pd2009-00574

    Original file (Pd2009-00574.docx) Auto-classification: Denied

    After a review of all of the findings, the Board therefore has no reasonable basis for recommending the left knee plica as an unfitting condition for separation rating. The Board therefore has no reasonable basis for recommending any additional unfitting conditions for separation rating. I have reviewed the subject case pursuant to reference (a) and, for the reasons set forth in reference (b), approve the recommendation of the Physical Disability Board of Review Mr. XXXX’s records not be...

  • AF | PDBR | CY2012 | PD 2012 00809

    Original file (PD 2012 00809.txt) Auto-classification: Approved

    The CI was then medically separated with a 10% disability rating. All records and exams refer to bilateral lower leg pain. In regards to the bilateral leg conditions combined under a single 5003 rating by the PEB, the Board unanimously recommends that each leg be individually unfitting and individually rated.

  • AF | PDBR | CY2012 | PD2012-00656

    Original file (PD2012-00656.pdf) Auto-classification: Denied

    That MEB forwarded bilateral exertional compartment syndrome; left leg status post (s/p) anterior compartment release with recurrent anterior and lateral exertional compartment syndrome; bilateral leg pain and numbness secondary to the first two conditions; and left leg anterior compartment fascial defect s/p anterior compartment release to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E. Pre-Separation) – Effective Date...

  • AF | PDBR | CY2013 | PD-2013-00094

    Original file (PD-2013-00094.rtf) Auto-classification: Denied

    No other conditions were identified by the MEB.The IPEB adjudicated “chronic or exertional compartmental syndrome in the bilateral lower legs status post (s/p)bilateral fasciotomies of the anterior and lateral compartments” as unfitting, with a combined rating of 20% (10% for each leg w/the bilateral factor) with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).The CI appealed to the Formal PEB; however, he withdrew his appeal and was medically separated. The...