RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  MARINE CORPS 
SEPARATION DATE:  20030930 

 
NAME:  XX 
CASE NUMBER:  PD1200882 
BOARD DATE:  20130123 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an  active duty SSgt/E-6 (4421/Legal Services Specialist), medically 
separated  for  chronic  bilateral  tibial  stress  reaction.    He  did  not  improve  adequately  with 
treatment to meet the physical requirements of his Military Occupational Specialty or satisfy 
physical fitness standards.  He was placed on limited duty and referred for a Medical Evaluation 
Board  (MEB).    The  MEB  forwarded  chronic  bilateral  tibial  stress  reaction  to  the  Physical 
Evaluation  Board  (PEB)  as  a  medically  unacceptable  condition  for  adjudication.    No  other 
conditions were forwarded to the PEB.  The PEB adjudicated the chronic bilateral tibial stress 
reaction condition as unfitting, rated 10%, with application of the Veterans Affairs Schedule for 
Rating Disabilities (VASRD) and SECNAVINST 1850.4E.  The CI did not appeal and was medically 
separated with a 10% disability rating.   
 
 
CI  CONTENTION:    “Permanent  pain  and  life/lifestyle  changing  impact.    Please  see  enclosed 
letter.    Access  to  all  existing  VA  records  is  granted.    See  attached/enclosed  letter  and  VA 
records.”  In the letter the CI cites his bilateral tibial stress fractures as well as a panic disorder 
and painful knees, back and hands.   
 
 
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.    The  bilateral  tibial  stress  reaction 
condition,  as  requested  for  consideration,  meets  the  criteria  prescribed  in  DoDI  6040.44  for 
Board purview.  The other requested conditions (panic disorder, knees, back and hands) 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.   
 
 
RATING COMPARISON:   
 

Code 
5022-5003 

Rating 
10% 

Service IPEB – Dated 20030707 
Condition 
Chronic  Bilateral  Tibial 
Stress Reaction 
 
 
↓No Additional MEB/PEB Entries↓ 
Combined:  10% 
*Increased to 50% from 20041105. 
 
 
 
 

VA (~1 Mos. Post-Separation) – All Effective Date 20031001 
Condition 
Stress Fracture, Left Tibia 
Stress Fracture, Right Tibia 
Bursitis Left Hip 
Panic Disorder w/o Agoraphobia 
0% X 1 / Not Service-Connected x 2 
Combined:  50% 

Rating 
10% 
10% 
10% 
30%* 

Code 
5022 
5022 
5019 
9412 

Exam 
20030828 
20030828 
20030828 
20030902 
 

ANALYSIS SUMMARY:   
 
Chronic Bilateral Tibial Stress Reaction Condition.  The CI was first noted to have possible “shin 
splints,” tibial shaft stress fractures, in late 2000.  He continued to have pain over the next few 
years and was managed with activity limitations and medications.  Despite this, his symptoms 
worsened and prevented him from meeting full duty requirements.  In October 2002, he was 
noted to have bilateral tibial stress fractures confirmed on a bone scan.  The narrative summary 
dictated  on  30  April  2003,  5  months  prior  to  separation.    The  CI  reported  that  his  pain  had 
worsened over time and increased with activity with minimal improvement from medications.  
On examination, the gait was normal and the hips, knees and ankles had full (ROM) without 
pain.  However, there was tenderness to palpation along the anteromedial aspect of the tibia 
from  near  the  knee  to  the  ankle  (bilaterally  implied).    X-rays  showed  no  obvious  increased 
thickening about the bone or signs consistent with inflammation.  At the MEB examination on 
16  May  2003,  the  CI  reported  no  specific  symptoms  related  to  the  stress  fractures.    The 
examiner documented no specific findings.  At the VA Compensation and Pension examination 
on 28 August 2003, (4 weeks prior to separation), the CI reported constant pain aggravated by 
walking.    The  gait  was  normal.    The  fibula  and  tibia  were  normal  on  examination,  although 
elsewhere in the narrative it was noted that the tibias were tender to palpation along the shaft.  
The  ROM  of  the  hips,  knees  and  ankles  was  normal  other  than  the  left  hip  which  also  had 
bursitis.  X-rays were normal.   
 
The  Board  directs  attention  to  its  rating  recommendation  based  on  the  above  evidence.    It 
noted that each tibia was separately painful and, by report, positive on the bone scan.  The PEB 
rated the bilateral tibial stress reaction as a single condition at 10% and coded it at 5022-5003, 
periostitis and degenerative arthritis.  The VA rated each leg at 10% coded 5022.  The Board 
considered  the  coding  options  and  ratings. 
  The  Board  majority  noted  that  without 
incapacitation or limitation in motion, neither the 5003 or 5022 codes support greater than a 
combined  10%  disability  rating.    After  due  deliberation,  considering  all  of  the  evidence  and 
mindful of VASRD §4.3 (Resolution of reasonable doubt), the Board majority concluded there 
was insufficient cause to recommend a change in the PEB adjudication for 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.    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 stress fracture condition and IAW VASRD 
§4.71a, the Board, by a 2:1 vote, recommends no change in the PEB adjudication.  The minority 
voter, who supported separate ratings for each leg, did not elect to submit a minority report.  
There were no other conditions within the Board’s scope of review for consideration.   
 

   2                                                           PD1200882 
 

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

VASRD CODE  RATING 
5022-5003 

10% 
10% 

COMBINED 

UNFITTING CONDITION 
Chronic Bilateral Tibial Stress Fracture 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120618, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

           xx 
           Director 
           Physical Disability Board of Review 

   3                                                           PD1200882 
 

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 21 Feb 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: 
 
 
 
 
 

 
 
 
 

 

 

     
 
 
 
 

-  former USN  
-  former USN  
-  former USMC 
-  former USN   
-  former USMC 
-  former USN  
-  former USN   
-  former USN 
-  former USMC 
-  former USMC 
-  former USMC 
-  former USMC 
 
  

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xxxx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

   4                                                           PD1200882