RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01215
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20040501

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Multichannel Transmission Systems Operator/Maintainer, medically separated for “chronic left Achilles tendonitis” with a disability rating of 10%.  

CI CONTENTION:  The CI submitted a lengthy contention for a condition that is not in scope.  In addition, he contends his current condition supports higher rating.  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 - 20040301	VARD - 20040818	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Achilles Tendonitis	5024	10%	Left Achilles Tendon Rupture	5024-5271	20%	20040324	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:

Left Achilles Tendonitis.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left Achilles condition began with a tendon rupture in August 2003 while playing basketball.  He was treated with a surgical repair the following day.  At the 06 May 2003 Physical Therapy visit, 12 months before separation, physical examination revealed left ankle range of motion (ROM) of dorsiflexion to 0 degree (normal 20) and plantar flexion to 30 degrees (normal 45); painful motion not addressed.  The 06 February 2004 MEB NARSUM examination, 3 months prior to separation, noted complaints of left chronic Achilles tendonitis.  Physical examination showed left ankle goniometric ROM of dorsiflexion to 0 degree (normal 20) and plantar flexion to 45 degrees (normal); painful motion not addressed.  

At the 24 March 2004 VA Compensation and Pension (C&P) evaluation, 1 month before separation, the CI reported left Achilles tendon pain with prolonged standing, walking and running.  Physical examination showed an antalgic gait, left ankle ROM of dorsiflexion 0 degrees (normal 20) and plantar flexion 45 degrees (normal), with painful motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left Achilles tendonitis condition 10%, coded 5024 (tenosynovitis), citing dorsiflexion 0 degrees.  The VA rated the left Achilles tendon condition 20%, coded 5024-5271 (tenosynovitis-ankle, limited motion), based on the C&P examination 1 month before separation, citing marked ankle limited motion.  The panel agreed that the ROM examinations proximate to separation were consistent with the “marked” limitation of motion required for the maximum 20% rating under this code, and were supported by the preponderance of STR and VA evidence documenting an abnormal gait.  Because there was no ankylosis, nonunion or malunion, VASRD §4.71a offers no applicable joint code which would yield a rating higher than the 20% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the left Achilles tendonitis condition, coded 5271.

BOARD FINDINGS:  In the matter of the left Achilles tendonitis condition, the panel unanimously recommends a disability rating of 20%, coded 5271 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	
Left Achilles Tendinitis	5271	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160926, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170018516, 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.

Sincerely,	
Enclosure