RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00945
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090109

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Heavy Construction Equipment Operator, medically separated for “marked limitation of motion in right ankle” with a disability rating of 20%.   

CI CONTENTION:  No specific contention was made.  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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20081106	VARD – 20090630 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Marked Limitation of Motion in Right Ankle	5271	20%	Residuals, Open Reduction Internal Fixation (ORIF) Fractures of Right Distal Tibia and Fibula with Reduced Range of Motion	5271	20%	20081203	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Marked Limitation of Motion in Right Ankle.  According to the service treatment record and MEB narrative summary (NARSUM), the CI sustained a twisting injury to the right ankle while playing football during physical training on 28 September 2007.  He was found to have distal tibia and fibula fractures and underwent open reduction internal fixation (ORIF) surgery the same day.  Despite physical therapy, he continued to have pain and decreased range of motion (ROM), and evaluations by two foot and ankle specialists determined that repeat surgery was not indicated.  
During the 6 June 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 7 months prior to separation, physical examination showed a surgical scar, no tenderness or swelling, and reduced ROM in all planes.  The 8 July 2008 MEB NARSUM examination, 6 months before separation, noted complaints of chronic, daily right ankle pain.  Physical examination findings were repeated from the MEB examination.  A right ankle ROM study by physical therapy on 8 August 2008 showed dorsiflexion of 0 degrees (normal 20) and plantar flexion of 25 degrees (normal 45), after repetition.  There was slight swelling, but no atrophy or deformity.  

At the 3 December 2008 VA Compensation and Pension (C&P) examination, 1 month after separation, the CI reported continuous right ankle pain.  The examiner noted a normal gait, and right ankle ROM showed dorsiflexion of 5 degrees and plantar flexion of 30 degrees, with pain.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 20%, coded 5271 (ankle, limited motion of) citing marked limitation of motion.  The VA also rated the right ankle condition 20%, coded 5271, based on the C&P examination, citing marked limited motion of the ankle.  Members 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.  The panel noted the underlying cause for the ankle impairment was related to residuals of the tibia and fibula fractures, and considered rating under code 5262 (tibia and fibula, impairment of).  However, nonunion or malunion was not present to support that approach.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded 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 recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.  

AR20180013234, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.