RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXX 
BRANCH OF SERVICE:  MARINE CORPS 
CASE NUMBER:  PD1201015                                                                   SEPARATION DATE:  20031131 
BOARD DATE:  20130124 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  LCpl/E-3  (3521/Basic  Automotive  Mechanic) 
medically separated for compartment syndrome.  Symptoms were first identified in early 2002 
and compartment syndrome was diagnosed in September of that year.  In October 2002, the CI 
underwent left lower extremity anterior and lateral fascial compartment releases.  Despite this 
surgical  intervention  and  follow-on  physical  therapy,  the  CI  was  not  able  to  meet  the 
requirements  of  his  Military  Occupational  Specialty  or  physical  fitness  standards.    He  was 
consequently placed on Limited Duty and referred for a Medical Evaluation Board (MEB).  In 
March  2003,  the  MEB  identified  the  “Left  lower  extremity  pain,  etiology  unknown”  and 
forwarded  it  as  the  only  condition  for  Physical Evaluation  Board  (PEB)  adjudication.    In  April 
2003 prior to meeting the PEB, the CI was brought to the emergency room complaining, "I can't 
move my legs or my left arm."  The examination failed to provide a medical explanation for his 
symptoms,  the  CI  was  admitted  to  the  in-patient  psychiatric  service  with  a  presumptive 
diagnosis  of  conversion  disorder.    He  was  discharged  3  days  later  and  a  mental  health 
addendum  to  the  MEB  was  forwarded  to  the  PEB  with  the  following  diagnosis:    Conversion 
disorder  with  motor  and  sensory  deficit,  anxiety  disorder  not  otherwise  specified  weakness, 
and  altered  sensorium  in  lower  extremities  bilaterally  and  upper  left  extremity  history  of 
compartment  syndrome  and  left  superficial  peroneal neuropathy.   No other  conditions  were 
submitted by the MEB.  The PEB adjudicated “History of compartment syndrome” as Category I 
(unfitting)  with  “left  lower  extremity  pain”  and  “left  superficial  peroneal  pain”  deemed  as 
related Category I diagnoses; combined disability was rated as 20%.  All other diagnoses of the 
MEB mental health addendum were judged as Category III (not unfitting and not contributing).  
The CI made no appeals and was medically separated with a 20% service disability rating. 
 
 
CI CONTENTION:  The application states “I received 20% from the USMC and the VA lower it to 
10%  for  no  proper  reason”  [sic].    He  does  not  elaborate  or  specify  a  request  for  Board 
consideration of any additional conditions. 
 
 
SCOPE  OF  REVIEW:    The  Board  wishes  to  clarify  that  the  scope  of  its  review  as  defined  in 
Department of Defense Instruction (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 rating for the unfitting compartment syndrome is addressed 
below.    The  related  Category  I  diagnoses  of  left  lower  extremity  pain  and  left  superficial 
peroneal  neuropathy  are  also  addressed  below.    The  other  conditions  judged  by  the  PEB  as 
Category III were not alluded to in the application and are not judged to have been requested; 
they  do  not  meet  scope  requirements.    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: 
 

Service PEB – Dated 20030918 
Condition 
History of Compartment Syndrome 
Left Lower Extremity Pain 
Left Superficial Peroneal Neuropathy 
Weakness  And  Altered  Sensorium  In 
Lower Extremities Bilaterally 
And Upper Left Extremity 
Anxiety Disorder 
Conversion Disorder With Motor And 
Sensory Deficit 
↓No Additional MEB/PEB Entries↓ 
Combined:  20% 

Rating 
10% 
10% 

Code 
5399-5312-8723 
5399-5312 
Related Category I 
Related Category I 

Category III 

Category III 
Category III 

VA (5.5 Mos. Pre-Separation) – Effective 20031201 
Condition 
Compartment 
syndrome,  left  lower 
extremity, 
peroneal 
nerve 

Rating 

Exam 

Code 

8721 

10% 

20030618 

Not Service Connected x 4 

20030618 

Combined:  10% 

 
 
ANALYSIS  SUMMARY:    The  Board  wishes  to  clarify  that  it  is  subject  to  the  same  laws  for 
disability entitlements as those under which the Disability Evaluation System (DES) operates.  
While  the  DES  considers  all  of  the  member's  medical  conditions,  compensation  can  only  be 
offered for those medical conditions that cut short a member’s career, and then only to the 
degree  of  severity  present  at  the  time  of  final  disposition.    However  the  Department  of 
Veterans  Affairs,  operating  under  a  different  set  of  laws  (Title  38,  United  States  Code),  is 
empowered to compensate all service-connected conditions and to periodically reevaluate said 
conditions  for  the  purpose  of  adjusting  the  Veteran’s  disability  rating  should  the  degree  of 
impairment vary over time. 
 
History of Compartment Syndrome Condition.  At the MEB exam accomplished 8 months prior 
to separation, the CI reported that his foot fell asleep due to nerve damage and that he had 
surgery on his left leg for compartment syndrome in October 2002.  The MEB physical exam 
simply  noted  scar  on  left  leg.    The  narrative  summary  also  prepared  8  months  prior  to 
separation,  stated  that  the  CI  first  presented  in  May  2002  with  symptoms  consistent  with 
chronic exertional compartment syndrome.  He underwent further evaluation to rule out tibial 
stress fractures or neuropathic pathology.  Finding no previous specific diagnosis, he underwent 
compartment pressure measurements on 6 September 2002.  At that time, he was found to 
have significant elevation of compartment pressures of the anterior and lateral compartments 
of  the  left  leg  with  exercise.    The  CI  underwent  surgical  intervention  which  consisted  of  left 
lower extremity anterior and lateral fascial compartment releases on 21 October 2002.  Since 
that time, he has had minimal recovery with continued intermittent moderate pain as well as 
occasional numbness in the leg and foot region.  He was unable to run, unable to wear boots or 
boot bands.  Previous electromyography and nerve conduction studies (EMG/NCS) showed an 
absent superficial peroneal nerve response but no level was identified.  The examiner opined 
that the significance of this finding was unknown.  Physical examination was “fairly normal.”  He 
had a well-healed surgical incision consistent with the surgical history as described.  He had full 
range-of-motion of the ankle and his neurologic examination was intact.  Plain film X-rays were 
normal.    Diagnosis  was  left  lower  extremity  pain  etiology  unknown  with  the  orthopedic 
surgeon’s opinion that the CI was unable to perform full duty and he should be restricted from 
running,  field  activities,  deployments  and  other  significant  exertion. 
  The  examiner 
recommended  that  “due  to  failure  of  recovery  from  his  surgical  procedure  that  the  CI  be 
considered for medical discharge.” 
 
Magnetic resonance imaging of the lumbar spine was performed on 4 June 2003 and revealed 
“very  mild  lumbar  spondylosis  at  the  lower  two  levels  as  described,  otherwise  negative.”  
Bilateral EMG/NCS testing was accomplished on two occasions, once prior to surgery and again 

2                                                           PD1201015 
 

after surgery.  Prior to surgery, the results revealed an abnormal left lower extremity superficial 
peroneal sensory nerve response that was consistent with an axonal loss lesion not involving 
the  motor  fibers  with  the  level  of  the  compromise  undetermined.    After  surgery,  repeat 
EMG/NCS were performed on both lower extremities and were completely normal, including 
sampling of the lumbosacral paraspinals. 
 
The VA Compensation and Pension exam accomplished 5 months prior to separation, noted a 
similar  history  the  one  presented  above  with  the 
following  significant  additions.  
Postoperatively,  he  continued  to  have  persistent  pain  at  all  times  with  weakness  of  the  leg, 
tingling and numbness, abnormal sensation, and sometimes loss of sensation with paralysis of 
the  left  lower extremity  occurring  intermittently.    He  missed 5  to  8 hours  of  work  per  week 
because  of  the  leg  and  back  condition.    He  also  developed  similar  pain  in  his  right  lower 
extremity  and  believed  he  might  have  compartment  syndrome of the  right  leg; however, he 
had not been formally diagnosed.  Physical examination was significant for normal posture and 
gait.  Extremities were non-tender, without evidence of edema or varicose veins.  Neurologic 
examination  was  significant  for  normal  strength  of  all  extremities  bilaterally.    Sensory  exam 
revealed  decreased  sensation  to  pinprick  and  light  touch  on  the  dorsal  aspect  of  both  feet.  
Coordination  was  within  normal  limits  as  were  his  deep  tendon  reflexes  bilaterally.    The 
author’s discussion of the CI’s compartment syndrome was significant for the following entry, 
“The  lower  extremity  examination  does  not  reveal  swelling,  localized  tenderness,  or  acute 
inflammatory  changes.    There  is  no  evidence  of  palpable  tenderness  in  the  calves  and  no 
evidence of recurrent compartment syndrome in the lower extremities.  As to this condition, he 
has no functional limitations.” 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB adjudicated the CI’s history of compartment syndrome as 20% disabling by applying two 
analogous  codes.    The  first  code  was  5399-5312,  for  moderate  dysfunction  of  the  Group  XII 
muscles IAW the Veterans Affairs Schedule for Rating Disabilities (VASRD §4.71a).  The second 
code was 5399-5312-8723, moderate neuralgia of the anterior tibial nerve (deep peroneal) also 
IAW VASRD §4.71a.  This coding and rating scheme is contrary to the guidance delineated by 
VASRD principle §4.55 Principles of combined ratings for muscle injuries that states, “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 coded and rated the same 
condition by applying a single VASRD code of 8721 and assigned a 10% evaluation based on a 
mild incomplete paralysis of foot movements.  The disability rating possibilities for the Group 
XII muscle code includes 0% for slight up to 30% for severe.  The CI’s bilateral lower extremity 
exam  revealed  normal  strength  and  reflexes  with  decreased  sensation  to  pinprick  and  light 
touch  on  the  dorsal  aspect  of  both  feet.    There  is  no  evidence  of  any  muscle  abnormality.  
Alternatively, if the PEB assigned a single peripheral nerve code, as did the VA, then different 
rating options would be applied.  Rating under peripheral nerve codes entails a judgment call 
regarding the severity of incomplete paralysis, especially the mild vs. moderate distinction.  By 
precedent,  the  Board  threshold  for  a  “moderate”  peripheral  nerve  rating  requires  some 
functionally significant motor and/or sensory impairment.  As evidenced above, the CI did not 
have any functionally significant motor or sensory impairment so a mild, 0%, rating would be 
recommended by this Board.  The proper application of either coding/rating scheme would not 
benefit  the  CI  and  there  is  no  VASRD  basis  for  recommending  a  higher  rating  than  the  20% 
conferred by the PEB in this case.  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  of  the  history  of 
compartment syndrome condition. 
 
 

3                                                           PD1201015 
 

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  history  of  compartment  syndrome  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 
History of Compartment Syndrome 

VASRD CODE 
5399-5312-8723 
5399-5312 
COMBINED 

RATING 
10% 
10% 
20% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120620, w/atchs. 
Exhibit B.  Service Treatment Record. 
Exhibit C.  Department of Veterans Affairs Treatment Record. 
 
 
 
 
 
 
 
 

 

         XXXX 
           Acting Director 
           Physical Disability Board of Review 

4                                                           PD1201015 
 

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 8 Mar 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 USMC 
-    former USMC 
-    former USN   
-   former USMC 
-   former USMC 
-   former USN  
-   former USMC 
  
 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  XXXXXX 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

5                                                           PD1201015