RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01929
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20060515

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Ammunition Technician, medically for “chronic left ankle pain,” with a disability rating of 0%.  

CI CONTENTION:  “Review all conditions.”  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 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 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 - 20060327	VARD - 20061026	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Ankle Pain	5299-5003	0%	Chronic Left Ankle Pain with Peroneal Tendon Tendonitis Versus Tendon Tear	5099-5024	0%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Left Ankle Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left ankle condition began in May 2003 after a fall on an obstacle course with a re-injury in January 2004 while wrestling during a physical training exercise.  Radiographic studies showed a normal left ankle and foot with no evidence of arthritis or structural abnormalities.  There was no surgical indication.  Despite treatment, the ankle condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for an MEB.  The MEB forwarded “chronic left ankle pain” for PEB adjudication.  On 8 November 2005, 6 months prior to separation, at a primary care clinic evaluation the CI complained of constant pain in the lateral left ankle that became worse with walking or running.  The examiner recorded the CI was able to stand on the balls of his feet without difficulty.  Additionally, the ankle was not tender to palpation and had full range of motion (ROM) with pain on maximum dorsiflexion.  At a follow-up primary care clinic appointment on 17 November 2005, 5 months prior to separation, physical examination revealed tenderness to palpation over the distal fibula, no muscle atrophy and full ROM.  During the MEB examination (recorded on DD Forms 2807 and 2808) dated 9 December 2005, 5 months prior to separation, the CI reported the use of an ankle brace when wearing civilian clothes.  Physical examination showed tenderness to palpation along the peroneal tendon, crepitus with motion, and full ROM, without mention of the absence or presence of painful motion.  The examiner diagnosed the CI’s condition as left peroneal tendonitis.  At the MEB NARSUM examination, performed on the same day as the MEB examination, the CI reported continued ankle lateral pain with activities.  The examiner noted the ankle showed no swelling or deformity, but displayed crepitus, slight tenderness to palpation and pain with resisted eversion.  The CI’s ankle displayed full ROM.  The final diagnosis was “chronic left ankle pain, most likely associated with peroneal tendon tendinitis versus tendon tear.”  The CI failed to attend his scheduled VA Compensation and Pension examination.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left ankle condition 0%, coded 5299-5003 (analogous to degenerative arthritis).  The VA rated the left ankle condition 0%, coded 5099-5024 (analogous to tenosynovitis).  There was no limitation of dorsiflexion or plantar flexion that supported a rating under the VASRD diagnostic code for limitation of motion (5271); however, there was evidence of painful motion causing functional loss supporting the 10% rating (based on §4.59, §4.40 and §4.45).  The Board considered alternative VASRD ankle and analogous codes, but all were less applicable and not advantageous to rating.  Because there was no ankylosis, nonunion or malunion, VASRD §4.71a offers no applicable joint code which would yield a higher rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the left ankle condition, coded 5299-5024.  

BOARD FINDINGS:  In the matter of the left ankle condition, the Board unanimously recommends a disability rating of 10%, coded 5299-5024 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Right Ankle Pain	5299-5024	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150711, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS
		   COMMANDER, NAVY PERSONNEL COMMAND	
	                          
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS          

Ref:  (a) DoDI 6040.44
	(b) PDBR ltr dtd 31 Jan 17 ICO XXXXXXXXXXXXXXXXXX      
	(c) PDBR ltr dtd 31 Mar 17 ICO XXXXXXXXXXXXXXXXXX
	(d) PDBR ltr dtd 30 Jan 17 ICO XXXXXXXXXXXXXXXXXX 
	(e) PDBR ltr dtd 04 Apr 17 ICO XXXXXXXXXXXXXXXXXX 
	(f) PDBR ltr dtd 31 Jan 17 ICO XXXXXXXXXXXXXXXXXX
	(g) PDBR ltr dtd 30 Jan 17 ICO XXXXXXXXXXXXXXXXXX
	(h) PDBR ltr dtd 27 Feb 17 ICO XXXXXXXXXXXXXXXXXX
      	(i) PDBR ltr dtd 17 Jan 17 ICO XXXXXXXXXXXXXXXXXX 

1.  Pursuant to reference (a), the recommendations of the Physical Disability Board of Review set forth in references (b) through (i) are approved.  The official records of the following individuals are to be corrected to reflect the stated disposition below:

     a. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 10 percent disability rating (increased from 0 percent) effective date of discharge.

     b. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 10 percent disability rating (increased from 0 percent) effective date of discharge.

     c. XXXXXXXXXXXXXXXXXX, former USMC: Entitlement to disability separation pay with a 10 percent disability rating (increased from 0 percent) effective date of discharge.

     d.  XXXXXXXXXXXXXXXXXX, former USMC: Entitlement to disability separation pay with a 20 percent disability rating (increased from 0 percent) effective date of discharge.

     e. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge.

     f. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge.

     g. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 20 percent disability rating (increased from 10 percent) effective date of discharge.

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS

     h. XXXXXXXXXXXXXXXXXX, former USN: Entitlement to disability separation pay with a 10 percent disability rating (increased from 0 percent) effective date of discharge.   
     
3.  Please ensure all necessary actions are taken to implement these decisions, including the recoupment of disability severance pay, if warranted, and notification to the subject members once those actions are complete.

	XXXXXXXXXXXXXXXXXX
	Assistant General Counsel
	(Manpower & Reserve Affairs)