RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE:  PD-2014-03774
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20031217

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3, Military Policeman, medically separated for “right foot pain with arthritic subtalar joint,” with a disability rating of 10%.  

CI CONTENTION:  The applicant makes no specific contention in his application.  The CI’s complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (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 Military 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 

SERVICE PEB – 20031022	VARD - 20080512  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Foot Pain…	5003	10%	Residuals, R/Ankle…	5010-5271	10%	20051101	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA RATINGS:  20%	

ANALYSIS SUMMARY:  

Right Foot Pain Condition.  The CI was in a motor vehicle accident (MVA) on 14 March 2003 and sustained a right closed talar (an ankle bone) fracture and dislocation.  This was treated with surgery and temporary placement of hardware.  Due to discomfort, the hardware was removed sooner than initially planned.  He was then entered into rehabilitation in physical therapy and his activities advanced as tolerated.  An X-ray on 18 July 2003 showed a good surgical repair with evidence of arthritis.  The narrative summary (NARSUM) was dated 25 August 2003.  It noted that the CI had completed 3 months of rehabilitation.  He was unable to run or jump, wear boots, and could not stand for prolonged periods of time.  On examination, the range of motion (ROM) was limited, as charted below, and strength reduced.  No description of the surgical scars was recorded.  A follow up X-ray on 9 September 2003 also noted good surgical repair without documentation of arthritis.  An examination in primary care on 29 October 2003, 2 months prior to separation, recorded that the ROM was normal.  Both swelling and tenderness were absent.  At the VA Compensation and Pension (C&P) examination performed on 1 November 2005, over 22 months after separation, the CI reported chronic pain with occasional flares associated with activity.  He denied instability and rarely used a cane.  He had missed 12 days of school the past year due to ankle and, to a lesser degree, back pain.  On examination, the ROM was reduced and painful.  The ankle was stable.  Slight weakness was present in dorsi-flexion and plantar flexion (toes up and down).  The gait was normal.  X-rays were not repeated.  The goniometric ROM evaluations in evidence which the Board weighed in arriving at its rating recommendation, with documentation of additional ratable criteria, are summarized in the chart below.  

Right Ankle ROM
(Degrees)	MEB ~4 Mo. Pre-Sep	VA C&P ~23 Mo. Post-Sep	
Dorsiflexion (20 Normal)	15	40 w/pain	
Plantar Flexion (45)	20	18	
Comment	Inversion and eversion weak.  4 months post-op	Limited by pain	
§4.71a Rating	10%	10%	

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the right foot pain at 10%, coded 5003 (degenerative arthritis), noting the presence of arthritis.  The VA also rated the right ankle at 10%, coded 5010-5271 (traumatic arthritis and limitation of motion).  The CI had repeat surgery in 2007, almost 4 years after separation, and the rating was increased by the VA to 20% for the ankle and an additional 10% adjudicated for the right foot, effective 18 August 2007.  The Board considered the evidence proximate to separation and found no criteria to support a higher rating regardless of code employed.  After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the right foot pain condition.  

BOARD FINDINGS:  In the matter of the right foot pain 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.  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 20140815, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB

MEMORANDUM FOR Commander

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXXXXX, AR20160011592 (PD201403774)

I have reviewed the enclosed Department of Defense Physical Disability Board of
Review (DoD PDBR) recommendation and record of proceedings pertaining to the
subject individual. Under the authority of Title 10, United States Code, section 1554a,
I accept the Board's recommendation and hereby deny the individual's application.
This decision is final. The individual concerned, counsel (if any), and any Members of
Congress who have shown interest in this application have been notified of this decision
by mail.

BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure

CF:
( ) DoD PDBR
( ) DVA