RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00930
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20061008

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Cannon Crewmember, medically separated for “synovitis right ankle,” with a disability rating of 0%.

CI CONTENTION:  The CI did not submit a contention in the 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 based upon a 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 - 20060810	VARD - 20070301	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Synovitis Right Ankle	5020	0%	Right Ankle Condition	5099-5020	NSC	20070109	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  None	

ANALYSIS SUMMARY:  

Synovitis Right Ankle.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right ankle condition began in December 2005 after physical training when his ankle became swollen.  A right ankle diagnostic imaging (MRI) study on 21 February 2006 was normal, with normal appearing bones and soft tissues, and intact tendons and ligaments.  A 4 April 2006 orthopedic surgery physical examination documented a normal gait and stance.  The right ankle examination revealed anterior swelling with anterior joint line tenderness.  There was no erythema (redness), warmth, deformity, weakness, or sensory abnormalities.  Ankle range of motion (ROM) was normal with pain with motion.  The ankle anterior drawer (assesses anterior talofibular ligament) test was negative.  There was no surgical indication, and conservative treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “right ankle synovitis” for PEB adjudication.  On 19 June 2006, physical therapy (PT) measured ROM for the MEB.  Right ankle plantarflexion was 50 degrees (45 normal) and dorsiflexion was 8 degrees (20 normal) degrees.  At the MEB NARSUM examination, on 20 July 2006, 3 months prior to separation, the CI reported pain at an intensity of 3/10, but when he stood or walked around for extended periods of time the pain will increase to a 7/10.  He also reported that the pain would wake him from sleep every couple of weeks.  The MEB physical examination noted swelling of right ankle without erythema or warmth.  Strength was 5/5 throughout with exception of dorsiflexion of right ankle 4/5 secondary to pain.  The author cited the 19 June 2006 PT measured ROM for the MEB.  At the 9 January 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported mild flare-ups every 2-3 weeks.  On examination of the ankle, the gait was normal and there was no limitation of motion or instability.  Pain-free right ankle plantar flexion was 45 degrees (45 normal) and dorsiflexion was 20 degrees (20 normal) degrees.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 0%, coded 5020 (synovitis), citing no compensable limitation of motion.  The VA denied the CI’s claim for service connection of the right ankle condition, coded it analogously to 5020 (synovitis), citing that the condition neither occurred in nor was caused by service.  There was no deformity for consideration under 5270 (ankle, ankylosis), 5272 (subastragalar or tarsal joint, ankylosis of), or 5273 (os calcis or astragalus, malunion of).  There was no excision of the astragalus for consideration under 5274 (astragalectomy).  The ROM values in the VA C&P examination did not support a minimum rating under the limitation of ankle motion (5271).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board majority concluded that there was insufficient cause to recommend a change in the PEB adjudication for the right ankle condition.  

BOARD FINDINGS:  In the matter of the right ankle condition and IAW VASRD §4.71a, the Board majority recommends no change in the PEB adjudication.  The single voter for dissent recommended modification of the disability rating and did not elect to submit a minority opinion.  There were no other conditions within the Board’s scope of review for consideration.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150603, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXXX, AR20170000865 (PD201500930)

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