RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01165
BRANCH OF SERVICE:  army	SEPARATION DATE:  20051119

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Automated Logistical Specialist, medically separated for “limitation of motion of right ankle” with a disability rating of 10%.

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 - 20050915	VARD - 20060209	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Ankle Loss of Motion	5271	10%	Right Ankle Instability S/P Reconstruction	5271	10%	20060121	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:

Right Ankle Loss of Motion.  According to the service treatment record and MEB narrative summary (NARSUM), the CI twisted his right ankle in February 2002 and then again in November 2004.  He underwent right ankle reconstruction surgery to correct a detached ligament in December 2004.  Despite physical therapy and ankle bracing the CI continued to have right ankle pain and instability, and was unable to return to full duty.  During the 18 May 2005 MEB NARSUM examination, 6 months prior to separation, the CI reported right ankle pain and instability.  Physical examination did not address his gait or provide right ankle findings.  The examiner opined, “he [CI] has difficulty walking on uneven surfaces, mostly due to ankle instability but also, in part, due to persistent labyrinthine imbalance [inner ear issue].  The Soldier cannot run without pain or instability.  The Soldier cannot road march or walk for distances greater than one mile without pain or drifting due to feeling of imbalance.”  At the physical therapy evaluation on 10 June 2005, 5 months before separation, the CI reported increased right ankle pain when he walked which caused swelling and discoloration.  Physical examination showed an antalgic gait, ankle swelling, and tenderness.  Range of motion was dorsiflexion to 10 degrees (normal 20) and plantar flexion was 30 (normal 45); painful motion and instability were not addressed.  During the 29 July 2005 MEB orthopedic evaluation, 4 months before separation, the CI reported right ankle pain and instability status post surgery with no improvement over his pre operation status.  He was still unable to walk on uneven ground without repetitive inversion episodes (twisting his ankle) and had persistent ankle pain.  Physical examination revealed dorsiflexion to 15 degrees and plantar flexion was 30; painful motion, gait, and instability were not addressed. 

At the 21 January 2006 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported continued right ankle pain since the surgery.  He was only able to walk one quarter of a mile or climb two flights of stairs before he had to rest due to pain.  Physical examination revealed an unsteady gait without use of an assistance device.  There was no right ankle swelling but tenderness was present.  Sensation to light touch was intact throughout the foot.  Right lower extremity motor strength was 5/5.  Dorsiflexion was approximately 10 degrees and plantar flexion was 20; painful motion was present.  Instability was not addressed.  Right ankle X-rays showed mild soft tissue swelling at the top outer portion of the ankle. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 10%, coded 5271 (ankle, limited motion).  The VA also rated the right ankle condition 10%, coded 5271, based on the C&P examination, citing painful motion.  The panel agreed that all the examinations proximate to separation were consistent with the “moderate” limitation of motion required for the 10% rating under code (5271), which was supported by the presence of an abnormal gait and swelling.  The panel considered alternative VASRD ankle and analogous codes, but all were less applicable and/or not advantageous to rating.  After due deliberation, considering all of 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.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170222, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20180004932, 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.

Sincerely,					      
Enclosure