RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  MARINE CORPS 

 
NAME:  XX                                             
CASE NUMBER:  PD1200656                                                               SEPARATION DATE:  20010915 
BOARD DATE:  20130215 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual was an Active Duty Marine, LCPL/E-3 (0151/Correspondence/Administration 
Clerk)  medically  separated  for  bilateral  exertional  compartment  syndrome.    After  evaluation 
and 8 months of limited duty (LIMDU), the CI was found fit for duty, with the diagnosis of fascial 
defect left anterior compartment, by the Physical Evaluation Board (PEB) in May 2000.  His left 
leg symptoms persisted and he developed similar symptoms on his right leg.  Despite surgical 
treatment of his left leg, he did not improve adequately to meet the physical requirements of 
his Military Occupational Specialty and he was referred for a second Medical Evaluation Board 
(MEB) in May 2001.  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.    The  MEB  forwarded  no  other 
conditions  for  PEB  adjudication.    The  PEB  adjudicated  the  bilateral  exertional  compartment 
syndrome as unfitting with a combined rating of 20% (10% for each leg) after application of the 
Veterans Affairs Schedule for Rating Disabilities (VASRD).  The remaining conditions forwarded 
by the MEB, outlined in the chart below, were determined to be Category II, conditions that 
contribute  to  the  unfitting  condition.    The  CI  made  no  appeals  and  was  medically  separated 
with a 20% disability rating. 
 
 
CI  CONTENTION:  The  CI  states:  “DUE  TO  ABNORMAL  SENSORY  NERVE  FINDINGS  INVOLVING 
BOTH PERSONEAL AND SURAL NERVE SUGGEST THAT A SCIATIC NERVE BRANCH INVOLVEMENT 
SENSE THE PERONEAL AND SUPERFICIAL NERVE ARE INVOLVED IN THE AREA BELOW THE KNEE 
FROM BURN THAT OCCURRED DURING OPERATION AND SCHEDULED SURGERY.” [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 the unfitting bilateral exertional compartment syndrome condition will be reviewed.  The 
other requested conditions, peroneal, sural, sciatic nerve, and burn are not within the Board’s 
purview.  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 Board for 
Correction of Naval Records (BCNR). 
 
 
 
 
 
 
 
 
 

Code 

7899-7804* 

10% 

20010724 

10% 

RATING COMPARISON: 
 

20010724 

Rating 
10% 

Rating 

Exam 

Code 
5399-5312 
Category II 
Category II 
Category II 
5399-5312 

VA (2.5 Mos. Pre-Separation) – Effective Date 20010916 
Condition 
Residuals, 
Fasciotomy, 
Anterior 
Compartment, 
Left Lower Leg 
No VA Rating 
Not Service-Connected x3 
Combined:  10%* 

Service PEB – Dated 20010712 
Condition 
Left Exertional Compartment Syndrome 
Bilateral Leg Pain and Numbness 
Lt. Leg Ant. Compartment Fascial Defect 
Lt. Leg s/p Ant. Compartment Release 
Right Exertional Compartment Syndrome 
↓No Additional MEB/PEB Entries↓ 
Combined:  20% 
*VASRD dated 20040310 changed 7899-7804 to 5399-5312, added 8722-7804 at 10% and 7804 at 10% with combined rating to 
30% effective 20010916 
 
 
ANALYSIS SUMMARY:  The Board makes note that some of the CI’s contended conditions are 
derived  from  Department  of  Veterans  Affairs  (DVA)  evaluations  performed  after  separation, 
diagnosing  conditions  which  were  not  addressed  by  the  PEB.    By  policy  and  precedent  the 
Board has limited its jurisdiction for recommending unadjudicated conditions as unfitting and 
subject  to  additional  separation  rating  to  those  conditions  which  are  evidenced  in  the  core 
Disability Evaluation System (DES) file.  The core DES file consists of the MEB referral document 
(NAVMED 6100/1), the PEB adjudication document, the report of medical board (including any 
addendums  or  referenced  examinations),  the  MEB  physical  exam,  the  commander’s  non-
medical  assessment  (NMA),  the  physical  profile(s),  and  any  written  appeals  or  internal  DES 
correspondence.  Contended conditions which are not eligible for Board recommendations on 
this basis remain eligible for submission to the BCNR. 
 
The PEB combined the left and right exertional compartment syndromes as a single unfitting 
condition  designated  as  bilateral  exertional  compartment  syndrome  on  the  PEB  proceedings 
document.  Also noted on the PEB document, are two separate analogous codes of 5399-5312 
each rated at 10% for a combined rating of 20% after application of the bilateral factor.  This 
clearly demonstrates the PEBs designation of the left and right legs as individually unfitting. 
 
Left Exertional Compartment Syndrome.  The report of medical board prepared 4 months prior 
to separation noted that the CI previously had a complete evaluation and 8 months of LIMDU 
for the left leg compartment syndrome.  He then presented to the orthopedic clinic in March of 
2000 with continued left lower leg pain.  He reported the initial mechanism of injury was an 
inversion injury to his left ankle while performing physical training that caused a lump to appear 
in his left shin.  He was diagnosed with a fascial defect in the left anterior compartment and 
underwent  anterior  compartment  fasciotomy  in  December  2000.    Although  the  CI  healed 
uneventfully, he failed to achieve a pain free level with activity.  He continued to complain of 
numbness in the leg with slightly increased pain and numbness with exertion, particularly after 
he ran for 15 minutes.  He also complained of recent onset of similar complaints in the right leg 
which were not present before December 2000.  Physical examination was significant for soft 
anterior and lateral compartments, no palpable fascial defects and a well healed lateral left leg 
incision.  Post exercise compartment pressures were evaluated.  The left anterior compartment 
pressure was 30 millimeter (mm) of mercury and the left lateral compartment was 46 mm of 
mercury.  As a control, the anterior and lateral compartments of the right leg were obtained 
and  they  were  63  and  60  respectively,  but  soft.    The  patient  worked  in  an  administrative 
capacity but he could not run or stand for long periods without pain and numbness in the leg.  
Both radiographic evaluations performed, bone scan and plain film X-rays, were normal.  Final 
diagnoses were as summarized in the rating comparison chart above.  The prognosis was that 
the  CI’s  exertional  compartment  syndrome  would  continue  to  keep  him  from  doing  the  full 
running, jumping, humping, heavy carrying and other activities required of the Marine Corps.  
Surgery  was  offered  to  the  CI  and  he  refused  further  surgical  treatment.    At  the  MEB  exam 

2                                                           PD1200656 
 

accomplished approximately 3 months prior to separation, the CI reported inability to stand for 
long periods and that he had surgery on his left leg after an injury.  The MEB physical exam 
noted nothing related to the CI’s leg pain. 
 
At the VA Compensation and Pension (C&P) exam performed a month prior to separation, the 
CI  reported  a  similar  history  to  the  one  above  with  the  following  significant  additional 
comments.  The CI reported that he continued to have symptoms described as bilateral leg pain 
and  numbness,  especially  in  the  left  leg.    The  symptoms  were  constant  with  uncomfortable 
flare-ups.    He  denied  difficulty  moving  his  leg.    Physical  examination  was  significant  for  no 
edema or varicosities, with normal peripheral pulses in the lower extremities.  Motor function 
was  within  normal  limits,  there  was  no  muscle  atrophy,  and  there  was  normal  sensation  to 
pinprick  and  touch  in  the  upper  and  lower  extremities.    Deep  tendon  reflexes  (DTRs)  in  the 
upper and lower extremities were symmetric and equal.  His gait was normal.  Examination of 
the knees and ankles was normal. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB applied the analogous VASRD code of 5399-5312 for the bilateral exertional compartment 
syndrome  and  awarded  a  combined  rating  of  20%,  10%  for  each  leg,  including  the  bilateral 
factor.    The  5312  code  is  for  a  Group  XII  muscle  disability  involving  the  lower  leg  which 
corresponds with the CI’s disabled lower legs.  It is noteworthy to mention that VASRD principle 
§ 4.55, Principles of combined ratings for muscle injuries, states that, “A muscle injury rating 
will not be combined with a peripheral nerve paralysis rating of the same body part, unless the 
injuries affect entirely different functions.”  The VA initially applied VASRD code 7899-7804 for 
the  residuals,  fasciotomy,  anterior  compartment,  left  lower  leg  condition  and  rated  it  10% 
disabling.  This coding and rating scheme was based on the presence of a tender, painful scar 
from the surgical procedure.  Three years later, the VA changed the code to 5399-5312 for the 
residuals, fasciotomy, anterior compartment, left lower leg condition and continued the 10% 
rating with the day after separation being the effective date.  This change in rating occurred 
after a more thorough review of symptoms revealed that the disability warranted a separate 
evaluation  for  the  muscle  injury.    This  changed  VA  rating  corresponded  with  the  PEB’s 
adjudication.    The  VASRD  code  5312  relies  on  designations  of  slight,  moderate,  moderately 
severe and severe muscle disability for arriving at the appropriate rating evaluation.  This rating 
scheme entails a judgment call regarding the severity of muscle disability, especially between 
both moderate levels and the severe level distinction.  A rigid assessment could require 3/5 or 
worse strength testing to merit the moderate rating.  More liberal rating applies any objective 
motor impairment or atrophy as a threshold for the moderate designation.   In this case, the 
only  impairment  was  due  to pain as  there  was no  motor  impairment  present  at the  time  of 
separation.  The impairment due to pain was more than slight as it resulted in curtailment of 
the  CI’s  military  career  but  did  not  cross  into  the  severe  category;  therefore,  it  was  either 
moderate or moderately severe.  There is no evidence present for review that gives the Board 
reason to recommend an increased in the rating level to the next higher moderately severe, 
20%, level.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 
(Resolution  of  reasonable  doubt),  the  Board  concluded  that  there  was  insufficient  cause  to 
recommend a change in the PEB adjudication for the left leg exertional compartment syndrome 
condition. 
 
Right  Exertional  Compartment  Syndrome.    As  previously  elaborated,  the  PEB’s  application  of 
two  separate  ratings  for  the  bilateral  exertional  compartment  syndrome  indicated  that  both 
legs  were  judged  to  be  unfitting.    The  clinical  information  present  in  the  left  exertional 
compartment  syndrome  section  above 
is  directly  applicable  to  the  right  exertional 
compartment syndrome and there is no additional information specific to the right exertional 
compartment syndrome condition at the time of separation. 
 
 

3                                                           PD1200656 
 

The Board directs attention to its rating recommendation based on the above evidence.  The 
same discussion present in the rating recommendation section above is applicable here also.  
The  PEB  applied  the  analogous  VASRD  code  of  5399-5312  for  the  bilateral  exertional 
compartment syndrome and awarded a combined rating of 20%, 10% for each leg, including the 
bilateral factor.  It is notable that the CI’s application for service-connection for the right leg 
compartment syndrome was denied by the VA.  The evidence in the service treatment record 
present  for  review  indicates  that  the  right  compartment  syndrome  had  only  become 
symptomatic  within  4  months  of  separation.    There  had  been  no  attempt  to  treat  this  new 
condition either conservatively or with established surgical procedures prior to separation.  The 
CI’s physical activity had already been limited by the left leg compartment syndrome so there 
was  no  evidence  of  any  functional  impairment  due  to  the  right  leg  condition.    The  Board’s 
deliberation determined that application of VASRD code 5312 would result in a rating of slight, 
0%, for the CI’s right exertional compartment syndrome and would be detrimental to the CI’s 
combined disability rating.  After due deliberation, considering all of the evidence and mindful 
of  VASRD  §4.3  (Resolution  of  reasonable  doubt),  the  Board  concluded  that  there  was 
insufficient cause to recommend a change in the PEB adjudication for the right leg exertional 
compartment syndrome 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 left leg exertional compartment syndrome condition and 
IAW VASRD §4.73, the Board unanimously recommends no change in the PEB adjudication.  In 
the matter of the right leg exertional compartment syndrome condition and IAW VASRD §4.73, 
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 
Left Exertional Compartment Syndrome Condition 
Right Exertional Compartment Syndrome Condition 

VASRD CODE  RATING 
5399-5312 
5399-5312 

10% 
10% 
COMBINED (w/ BLF)  20% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120606, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           X 
           Acting Director 
           Physical Disability Board of Review 

4                                                           PD1200656 
 

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW  
                                        BOARDS  

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 

Ref:   (a) DoDI 6040.44 

             (b) CORB ltr dtd 04 Apr 13 
 

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for 
the reasons provided in their forwarding memorandum, approve the recommendations of the PDBR 
that the following individual’s records not be corrected to reflect a change in either characterization 
of separation or in the disability rating previously assigned by the Department of the Navy’s 
Physical Evaluation Board: 
 
 
 
 
 
 
 
 
 
 
 
 

-  xformer USMC 
-  xformer USN  
-  xformer USMC 
-  xformer USMC 
-  xformer USN  
-  xformer USMC 
-  xformer USMC 
-  xformer USN  
-  xformer USMC 
-  xformer USN  
-  xformer USMC 
  
 

 
 
 
 
 
 
 
 
 
 
 

 

 

     
 
 
 
 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  x 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

5                                                           PD1200656