RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-00977
BRANCH OF SERVICE:  MARINE CORPS 	SEPARATION DATE:  20080715

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3 (Rifleman) medically separated for left medial talar arthrosis traumatic, rated at 10%.

CI CONTENTION:  His condition continues to worsen and negatively impact his daily activities.  His complete submission is at Exhibit A.  

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 when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Naval Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation. 

RATING COMPARISON:  

IPEB - Dated 20080325	VA* - (~2 Mos. Pre-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Medial Talar Arthrosis	5299-5003	10%	S/P Left Ankle Fracture	5003-5271	10%	20080515	
Ankle Fracture	Cat II	Left Ankle Scar	7805	0%	20080515	
Other MEB/PEB Conditions x 0 (Not in Scope)	Other x 9 	
RATING:  10%	COMBINED RATING:  20%	
*Derived from VA Rating Decision (VARD) dated 20080726 (most proximate to date of separation [DOS]).  

ANALYSIS SUMMARY:  

Left Ankle Talar Arthrosis (with [History of] Ankle Fracture).  The narrative summary (NARSUM) and treatment record noted the CI had onset of left ankle pain following an injury in 2005.  Left ankle MRI noted tibiotalar ligament abnormality with an associated avulsion fracture off the medial aspect of the talar dome.  Due to instability and pain, the CI had surgical repair of the medial talar osteochondral defect in 2006 and a second surgery in September 2007 (debridement and complete synovectomy).  He had a persistent osteochondral defect in his talar medial dome reported following surgery, and had recurrent complaints of left ankle pain and instability.  At the MEB exam, the CI reported continued left ankle pain greater than instability.  

The MEB physical exam of the left ankle noted slight left ankle weakness (“5- out of 5”), tenderness, “some proprioceptive imbalance” (decreased position sensation) and no lateral ankle laxity.  Range-of-motion (ROM) was dorsiflexion to 20 degrees (normal 20) and plantar flexion to 40 degrees (normal 45).  

At the VA Compensation and Pension (C&P) exam performed 2 months before separation, the CI reported severe left ankle pain with weakness, stiffness, giving way, lack of endurance, locking, fatigability, and dislocation.  Exam documented normal gait and posture.  The left ankle had tenderness with painful ROM of dorsiflexion to 18 degrees and plantar flexion to 40 degrees.  There was increased pain, fatigue, weakness and lack of endurance after repetition.  The two ankle scars were not tender.  Ankle X-ray was reported as normal.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB 10% rating was analogous to 5003 (arthritis, degenerative [hypertrophic or osteoarthritis]) and the VA 10% was analogous to 5271 (ankle, limited motion - moderate).  Any impact of the scar and/or prior fracture was considered under the ankle rating.  There was no deformity or malunion of any of the ankle bones for alternative or higher rating under other ankle codes.  There was insufficient evidence of any greater loss of ROM to approximate the “marked” degree of limitation of motion for a higher rating.  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 ankle condition(s).  

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 ankle condition(s) 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.  

The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140220, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

	
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 Jan 16

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, 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:

- XXXXXXXXXXXXXXXXXXXX, former USMC 
- XXXXXXXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXXXXXXX, former USMC   
- XXXXXXXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXXXXXXX, former USMC 
- XXXXXXXXXXXXXXXXXXXX, former USMC  
- XXXXXXXXXXXXXXXXXXXX, former USMC 
- XXXXXXXXXXXXXXXXXXXX, former USMC 

						  XXXXXXXXXXXXXXXXXXXX
	Assistant General Counsel
	(Manpower & Reserve Affairs)