Mr. Carl W. S. Chun | Director | |
Mr. Edmund P. Mercanti | Analyst |
Mr. Raymond V. O'Connor | Chairperson | |
Mr. Eric N. Andersen | Member | |
Mr. Thomas E. O'Shaughnessy | Member |
APPLICANT REQUESTS: That his discharge for weight control program failure be corrected to a medical discharge.
APPLICANT STATES: His medical records will support his request.
The applicant submits a letter from his wife to their elected representative in support of his application. In that letter she relates how her husband’s shins became painful on long marches where he had to carry a rucksack. He was prescribed pain medication and given profile restrictions for his shin pain. However, in contravention of the profile limitations, her husband’s first sergeant forced him to run and march with a rucksack. This lead to her husband experiencing intolerable pain while walking. Initial examinations, including interpretation of x-ray images of the shins, resulted in a diagnosis of shin splints. However, a subsequent nuclear bone scan showed that her husband had a “near stress fracture of the right shin.” She then states that her husband was a good soldier who always passed his physical training tests, and who had been on the Army Weight Control Program (AWCP) for some time. She adds that her husband’s processing for separation due to weight control failure had to be started over because of the paperwork on his overweight condition “was conveniently missed placed.”
In support of his request the applicant also submits a radiology examination report dated 19 May 1998 which shows the applicant did not have a stress fracture, but had bilateral shin splints, the right worse than the left.
EVIDENCE OF RECORD: The applicant's military records show:
He enlisted in the Regular Army on 21 April 1994, was awarded the military occupational specialty of satellite communications systems repairer, and was promoted to pay grade E-5.
On 3 February 1998 the applicant was found to weigh 209 pounds and have a body-fat content of 25.53 percent. The maximum allowable weight for his height and age was 189 pounds, and the maximum allowable body-fat content was 22 percent. The applicant was then entered into the AWCP.
On 9 February 1998 the applicant had a suspension of favorable personnel actions (commonly referred to as a flag) imposed against him due to his being found to exceed the allowable body-fat standards for his age.
The applicant was weighed periodically, with his weight recorded as 201 pounds on 3 April 1998, 204 pounds on 30 April 1998, 213 pounds on 1 June 1998, and 226 pounds on 26 August 1998.
On 24 September 1998 the applicant was given a separation physical examination. In the report of medical history the applicant completed, he stated “I’m in good health.” The physician conducting the examination concluded that the applicant was qualified for separation due to AWCP failure. The physician did not impose any physical profile restrictions on the applicant.
On 29 September 1998 the applicant was notified by his commander of his intent to recommend his separation due to AWCP failure, and of his rights in conjunction with that recommendation. The applicant waived all of his rights.
On 29 September 1998 the applicant’s commander recommended his separation due to AWCP failure. That recommendation was approved and the applicant was honorably discharged on 30 October 1998. He had 4 years, 6 months and 10 days of active service.
Army Regulation 635-40 provides that the medical treatment facility commander with the primary care responsibility will evaluate those referred to him and will, if it appears as though the member is not medically qualified to perform duty or fails to meet retention criteria, refer the member to a medical evaluation board. Those members who do not meet medical retention standards will be referred to a physical evaluation board (PEB) for a determination of whether they are able to perform the duties of their grade and military specialty with the medically disqualifying condition. For example, a noncommissioned officer who receives above average evaluation reports and passes Army Physical Fitness Tests (which have been modified to comply with the individual’s physical profile limitations) after the individual was diagnosed as having the medical disqualification would probably be found to be fit for duty. The fact that the individual has a medically disqualifying condition does not mandate the person’s separation from the service. Fitness for duty, within the perimeters of the individual’s grade and military specialty, is the determining factor in regards to separation. If the PEB determines that an individual is physically unfit, it recommends the percentage of disability to be awarded which, in turn, determines whether an individual will be discharged with severance pay or retired. An Army disability rating is intended to compensate an individual for interruption of a military career after it has been determined that the individual suffers from an impairment that disqualifies him or her from further military service. In this regard, the Army rates only conditions determined to be physically unfitting, thus compensating the individual for loss of a career.
Title 10, U.S. Code, chapter 61, Retirement or Separation for Physical Disability, provides for the medical retirement and for the discharge for physical unfitness, with severance pay, of soldiers who incur a physical disability in the line of duty while serving on active or inactive duty. However, the disability must have been the proximate result of performing military duty.
The Hughston Sports Medicine Foundation addresses shin splints and stress fractures as follows: “Shin splints is a term used to describe pain in the lower leg that occurs during exercise. This condition has many causes and can affect athletes at all fitness levels. One common cause of shin splints is posterior tibial syndrome (PTS). The pain associated with PTS occurs on the medial (inside) border of the tibia (shin bone). The pain present when you start exercising becomes less severe as you warm up but becomes worse than ever after you stop exercising. Posterior tibial syndrome often occurs in beginning runners, who are unaccustomed to the activity and running surface, but can occur in seasoned athletes when they change running surfaces, exercise in different shoes, or increase their intensity or duration of exercise. The condition most commonly mistaken for PTS is a stress fracture. A stress fracture of the tibia is a crack that develops in the shin bone over time from repetitive stress on the bone. Normally, your muscles absorb the shock put on your legs during activity. When you continuously pound your legs during an activity, such as distance running, soccer, or basketball, your muscles tire, losing much of their ability to absorb shock. When your muscles do not absorb shock well, stress on the bone increases. The bone cannot endure the increased stress so it begins to crack. To help detect a stress fracture, your doctor may take x-rays or a bone scan. However, these fractures can be quite difficult to diagnose because they may not show up on x-rays when they first develop. The treatment for shin splints must be tailored for each person according to whether the cause is PTS or a stress fracture and considering the person’s exercise habits. The most important form of treatment for PTS is rehabilitative exercises. Stretching before and after running, particularly the calf muscles, and strengthening your leg muscles through progressive resistance exercise usually help relieve the symptoms of PTS. In addition to rehabilitative exercises, your doctor and physical therapist may recommend some combination of changes in footwear, exercise intensity and duration, and running surface. Also, taking anti-inflammatory medications, such as aspirin or ibuprofen, and applying ice to the tender area immediately after exercise can help relieve symptoms. Your doctor may recommend you use orthotics (shoe inserts) to help support your foot and relieve stress in your leg. A person with compartment syndrome occasionally needs surgery to relieve the pressure in the muscle compartment. Stress fractures will heal in several weeks with rest, although you may need to wear a cast or brace. Your doctor may suggest swimming or riding a bicycle during this time to maintain cardiovascular activity while allowing the bone to heal.”
DISCUSSION: Considering all the evidence, allegations, and information presented by the applicant, together with the evidence of record and applicable law and regulations, it is concluded:
1. The applicant was determined medically qualified for separation at his separation physical examination. It is noted that the applicant stated that he was in good health and did not mention shin splints or stress fractures at that time.
2. Without a finding of medical disqualification, there was no basis to consider the applicant for a medical discharge or retirement.
3. While the applicant suffered from shin splints, that condition is remedial. As such, that condition would not have qualified the applicant for medical discharge or retirement.
4. The applicant exceeded the AWCP standards and continued to gain weight. At the time of his separation he was 22 pounds heavier then when he was placed on the AWCP. That weight gain certainly formed a basis for discharging the applicant for AWCP failure.
5. In view of the foregoing, there is no basis for granting the applicant's request.
DETERMINATION: The applicant has failed to submit sufficient relevant evidence to demonstrate the existence of probable error or injustice.
BOARD VOTE:
________ ________ ________ GRANT
________ ________ ________ GRANT FORMAL HEARING
___rvo ___ ____ena ____teo _ DENY APPLICATION
CASE ID | AR2001059203 |
SUFFIX | |
RECON | YYYYMMDD |
DATE BOARDED | 20010927 |
TYPE OF DISCHARGE | (HD, GD, UOTHC, UD, BCD, DD, UNCHAR) |
DATE OF DISCHARGE | YYYYMMDD |
DISCHARGE AUTHORITY | AR . . . . . |
DISCHARGE REASON | |
BOARD DECISION | DENY |
REVIEW AUTHORITY | |
ISSUES 1. | 108.04 |
2. | |
3. | |
4. | |
5. | |
6. |
AF | PDBR | CY2010 | PD2010-00973
The MEB and narrative summary (NARSUM) exam at four months prior to separation noted that the CI complained of chronic pain in the shin and foot, was unable to run without pain and rated this pain as 3-4 out of 10, with 10 being the worst. The Board noted that the CI’s condition was only somewhat improved by arch supports and there was no painful motion of the ankle or abnormal gait at the VA exam. In the matter of the right hip, right knee and migraine headaches conditions, and any other...
AF | PDBR | CY2012 | PD2012 01297
It noted that the CI had degenerative changes on X-ray (although an X-ray 2 years after separation was reportedly normal), tenderness on the MEB examination, and weakness with decreased ROM on the C&P examination. It noted that the CI had 4/5 weakness in both lower extremities on the C&P examination, even though it had been normal a month earlier and was also normal on the VA examination 7 years after separation. It noted that the CI had no symptoms on the more probative MEB examination...
AF | PDBR | CY2012 | PD2012 01403
The MEB characterized his condition as “exercise-induced compartment syndrome”EICS and forwarded it to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.ThePEB adjudicated bilateral lower leg pain secondary to EICS as unfitting, rated 0%, citing the Veterans Affairs Schedule for Rating Disabilities (VASRD).The CI made no appeals, and was medically separatedwiththat rating. The narrative summary (NARSUM) notes the CI had a lower leg pain that...
AF | PDBR | CY2009 | PD2009-00520
The CI did not appeal the case, and was thus medically separated with a 10% combined disability rating. The Board considered any additional lower extremity disability contributed from bilateral pes planus and healed stress fracture of the right tibia in rating the CI’s unfitting shin splint conditions. In the matter of the bilateral shin splints condition, the Board unanimously recommends that each leg be separately adjudicated as follows: an unfitting right shin splint condition, coded...
AF | PDBR | CY2014 | PD-2014-00867
Pre-Separation)Condition CodeRatingConditionCodeRatingExamBilateral Shin Splints (10% rating for each leg)…5299-526220%Right Anterior Tibialis Tendonitis52620%*20080922Left Anterior Tibialis Tendonitis52620%*20080922Other x 0 (Not in Scope)Other x 3 Combined: 20% Combined: 0%Derived from VA Rating Decision (VARD) dated 20090224 (most proximate to date of separation [DOS]) *VARD dated 20090805 increased the left and right anterior tibial tendonitis to 10% each effective 20081119. The PEB...
AF | PDBR | CY2012 | PD2012 00955
The bilateral lower leg conditions, characterized as “bilateral tibial periostitis” and “right femoral stress fracture,” were forwarded to the Physical Evaluation Board (PEB) . The CI was returned to full activity however she experienced recurrent activity limiting pain in the shins and right femur with a physical training test and battle stations exercise and MEB was initiated.The MEB narrative summary physical examination, 22 October 2001, noted the CI complained of bilateral shin pain...
AF | PDBR | CY2013 | PD-2013-02037
RATING COMPARISON : IPEB – Dated 20040617VA* -(5 days Post-Separation)Condition CodeRatingConditionCodeRatingExamBilateral Shin Splints50220%Delayed Union/Nonunion, Stress Fracture, Left Tibial Shaft5299-526210%20040816Shin Splints, Right Leg5299-5262NSC20040816Other x 0 (Not In Scope)Other x 6 RATING: 0%COMBINED RATING: 10% *Derived from VA Rating Decision (VARD)dated 20050609(most proximate to date of separation [DOS]). However, the option of not recommending separate disability ratings,...
AF | PDBR | CY2013 | PD2013 00001
In March 2003, approximately 11 months prior to separation, the CI was evaluated by orthopedic physician who indicated a normal right leg with normal range-of-motion (ROM); diagnosis of periotitis of right lower extremity was made.All treatment entries indicated full ROM, normal gait, and tenderness to palpation of the right leg. The PEB rated right leg pain condition at0% under code 5022(periostitis) for pain, while the VA rated the right leg condition at 10% as 5262 (impairment of tibia)...
AF | PDBR | CY2012 | PD 2012 01549
Post-Separation) All Effective Date 20030829 Condition Code Rating Condition Code Rating Exam Chronic LBP w/o Radicular Signs 5299-5295 10% Chronic LBP 5237 10% 20030930 Chronic B/L Shin Splints 5099-5022 0% B/L Shin Splints 5099-5022 NSC* 20030930 Lt Tibia Stress Fracture 5262 NSC* 20030930 Mild Pes Planus Not Unfitting No Corresponding VA Entry .No Additional MEB/PEB Entries. Although the CI experienced shin splint pain with the vigorous physical activity associated with military...
AF | PDBR | CY2012 | PD-2012-01524
RATING COMPARISON: Service IPEB Dated 20020722 VA All Effective Date 20030829 Condition Code Rating Condition Code Rating Exam Bilateral Chronic Shin Splints 5022 0% Chronic Shin Splints, Left Leg 5299-5262 10% STR* Chronic Shin Splints, Right Leg 5299-5262 0% STR* Combined: 0% Combined: 10% *No C&P examination completed ANALYSIS SUMMARY: The Boards authority as defined in DoDI 6040.44, resides in evaluating the fairness of Disability Evaluation System (DES) fitness determinations and...