RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00847
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041014

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

CI CONTENTION:  The CI claimed he should receive a higher rating for his ankle and identified additional conditions not listed by the MEB/PEB.  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 - 20040716	VARD - 20041025	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Ankle Pain	5003	0%	Residuals of Right Ankle Surgery	5299-5271	10%	20031125	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Right Ankle Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent right ankle surgery in August 2003 for right ankle arthroscopy and resection of an anterolateral meniscoid lesion, for impingement and pain following a Grade III ankle sprain.  

At the 25 November 2003 VA Compensation and Pension (C&P) examination, 11 months before separation, the CI reported an inability to sustain heavy physical activity without discomfort.  The ankle only swelled after prolonged standing.  He experienced daily pain and popping.  Examination showed range of motion (ROM) measurements of dorsiflexion to 7 degrees (normal 20) and plantarflexion to 44 degrees (normal 45) with painful motion present.  The CI walked with a normal gait without deformity or neurovascular complications.  

At the 17 February 2004 orthopedic evaluation, 8 months before separation, the CI noted that the surgery improved the ankle, but limitations remained, such as the inability to run or ruck.  The examiner noted the CI dorsiflexed to 15 degrees and plantar flexed to 40 degrees.  The examiner noted normal sensation, with tenderness over the lateral aspect of the ankle.  

The 15 April 2004 MEB NARSUM examination, 6 months prior to separation, noted complaints of right ankle pain and inability to run greater than a quarter of a mile without severe discomfort.  Physical examination showed the CI dorsiflexed to 10-12 degrees (normal 20) and plantar flexed to 20 degrees (normal 45), and “at the extremes of these motions there is discomfort noted particularly on the lateral aspect of the ankle.”  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 0%, coded 5003 (degenerative arthritis), citing non-ratable limitation of motion.  The VA rated the right ankle condition 10%, coded 5299-5271 (analogous to limited ankle motion), citing moderate limited ankle motion.  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 panel considered alternative VASRD ankle and analogous codes, but all were less applicable and not advantageous to rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the ankle condition, coded 5003.  

BOARD FINDINGS:  In the matter of the chronic right ankle pain condition, the panel unanimously recommends a disability rating of 10%, coded 5003 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel 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	
Chronic Right Ankle Pain	5003	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160921, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170017175, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	
Enclosure