RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2015-01579
BRANCH OF SERVICE:  MARINE CORPS 	SEPARATION DATE:  20080415

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Rifleman, medically separated for “chronic right ankle pain” with a disability rating of 10%.   

CI CONTENTION:  The CI made no specific contention.  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination is based on 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(s) at the time of separation.  The panel 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 panel 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 - 20080204	VARD - 20080806	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Ankle Pain	5299-5003	10%	Right Ankle Problems	5271	NSC	NA	
Chondromalacia … Talus	Cat II					
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NSC	

ANALYSIS SUMMARY:  

Chronic Right Ankle Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI suffered an injury of his ankle (conflicting reports for mechanism) in August 2006 while deployed to Iraq.  He was treated in theater (X-rays negative), but suffered persistent pain and swelling after redeployment.  Magnetic resonance imaging was normal, but diagnostic arthroscopy (May 2007, 11 months before separation) identified chondromalacia (damaged joint cartilage) that was debrided (partial chondroplasty of talar dome).  There were no STR entries that suggested any significant range of motion (ROM) limitation, joint instability or impingement, or other VASRD-ratable findings.  

The 3 December 2007 NARSUM examination, 4 months prior to separation, documented that the CI “still complained of discomfort with impact activities, although it was less than before surgery … does not have any day in and day out discomfort with everyday walking … no complaint of instability, simply pain with prolong activities.”  The physical examination recorded a normal gait, “mild” tenderness, and joint stability.  Measured ROM was dorsiflexion to 20 degrees (normal) and plantar flexion to 40 degrees (45 normal), without comment regarding painful motion.  There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB’s 10% rating under code 5299-5003 (analogous [correct prefix is 5099] to degenerative arthritis).  The PEB additionally adjudicated “chondromalacia of the anterolateral aspect of the talus” as a Category II condition (contributes to the unfitting condition but is not separately ratable).  Members agreed that this diagnosis was intrinsic to the rated condition and not associated with any findings that could be separately rated without violation of VASRD §4.14 (avoidance of pyramiding).  The VA referenced only the STR evidence and did not service connect the condition, citing failure to demonstrate “permanent residual or chronic disability.” 

Given the absence of ankylosis or fracture with nonunion or malunion, there is no applicable joint code which would yield a rating higher than the PEB’s 10%.  The only route to a higher rating would be under code 5271 (limitation of motion) that confers 20% for “marked” limitation, and that was not supported by the above ROM evidence (normal, or nearly so).

After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel 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 panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.

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

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150625, 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

      In accordance with reference (a), I have reviewed the cases listed below and 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:

		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
	 	- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC

		
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