RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00938
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041224

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Reserve E2, Field Artillery Surveyor, medically separated for “chronic right foot/ankle pain” with a disability rating of 0%.  

CI CONTENTION:  “Injury was not properly diagnosed.  Recent findings prove there is permanent nerve damage.”  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 conditions at the time of separation.  The panel has neither the role nor the authority to compensate for progression or complications of service-connected conditions after separation.  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 - 20041124	VARD - 20051202	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Foot/Ankle Pain	5099-5003	0%	Right Foot and Ankle Injury	5271	NSC	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Right Foot/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 after falling on his ankle.  Radiographic (X-ray) studies showed no fracture.  Also, a follow-on magnetic resonance imaging (MRI) on his foot was negative and no surgical intervention was warranted.  The 15 September 2004 MEB NARSUM orthopedic examination, 3 months prior to separation, noted complaints of continued pain and unable to walk without pain.  The physical examination showed full range of motion (ROM) and a significant limp.  Functional limitations were due to pain.  He had ankle/foot joint laxity (positive anterior drawer and talar tilt).  He had normal strength in foot dorsiflexion and plantar flexion.  Prognosis for further recovery as a civilian was considered good.  There was no VA Compensation and Pension (C&P) examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 0%, analogously coded 5099-5003 (degenerative arthritis), citing no subluxation or loss of joint motion.  The VA did not service-connect the right ankle condition citing that the CI failed to report for his scheduled C&P examination.  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 §4.40, §4.45 and §4.59).  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 chronic right foot/ankle pain condition, coded 5099-5003.  

BOARD FINDINGS:  In the matter of the chronic right foot/ankle pain condition, the panel unanimously recommends a disability rating of 10%, analogously coded 5099-5003 IAW VASRD §4.59.  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 Foot/Ankle Pain	5099-5003	10%	

The following documentary evidence was considered:

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

AR20170015825, 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