RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01723
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20070630

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Field Artillery Fire Control Man, medically separated for “chronic right ankle pain” with a disability rating of 10%.  

CI CONTENTION:  The CI contends his condition continues to worsen and negatively impact his daily activities.  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 - 20070418	VARD - 20130918	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Ankle Pain	5299-5003	10%	Right Ankle Injury 	5271	NSC	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Right Ankle Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right ankle condition began in September 2004 while performing on the obstacle course.  Diagnostic imaging (MRI) in July 2005 revealed an old ligament injury (ATFL and CFL injury) and concomitant small fragment near the anterior tip of the fibula and mild arthritic changes.  An electrodiagnostic test (EMG) in January 2006 was normal.  

At the time of the 19 July 2006 orthopedic clinic appointment, 11 months prior to separation, the examiner recorded right ankle swelling and tenderness to palpation with decreased range of motion (ROM) of 15 degrees of dorsiflexion (20 normal).  
During the 7 January 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported chronic right ankle pain that interfered with his ability to walk or stand for long periods of time.  Physical examination showed no edema or ecchymosis.  There was tenderness to palpation and strength was slightly decreased (+4/5).  

The 10 January 2007 MEB NARSUM and 23 March 2007 addendum, 3 and 6 months prior to separation, noted complaints of diffuse pain to the right ankle and pain with any attempt to walk or weight bear and especially with going upstairs or attempting to run.  Physical examination showed tenderness especially in the posterior aspect of the right ankle.  There was mild edema.  The right ankle ROM following repetition showed dorsiflexion of 20 degrees (normal 20 degrees) and plantar flexion of 30 degrees (normal 45 degrees).  The ROM was noted to be exquisitely tender and marked pain of the posterior aspect of the ankle.  Strength was normal.  

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 rated the right ankle condition 10%, coded 5299-5003 (arthritis, degenerative).  The VA did not service connect the right ankle condition, citing the CI failed to attend his VA examination and the evidence did not show a current diagnosed disability.  

The right ankle limitation of motion recorded at the time of the MEB NARSUM examination was mild.  However, there was pain with use supporting a 10% rating for functional loss (§4.40 and 4.59).  All members agreed the limitation of motion was not “marked,” therefore the next higher rating under 5271 was not justified.  The panel considered alternative VASRD ankle and analogous codes, but all were less applicable or not advantageous to rating.  

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 20160705, 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: PHYSICIU. DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDAT IONS 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 USMC
-	XXXXXXXXXXXXXXXXXX, former USMC
-	XXXXXXXXXXXXXXXXXX, former USMC
-	XXXXXXXXXXXXXXXXXX, former USMC

                        XXXXXXXXXXXXXXXXXX
                        Acting