RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX	CASE:  PD-2017-01302
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20061020

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Trainee, medically separated for “limitation of motion and chronic right ankle pain” with a disability rating of 10%.   

CI CONTENTION:  The CI contends the right ankle damage was more severe requiring surgery in 2016.  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 – 20061004	VARD - 20070503	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Ankle Pain	5271	10%	Right Ankle Sprain	5271	10%	20070117	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Limitation of Motion and Chronic Right Ankle Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right ankle condition began in March 2006 after sustaining a plantar flexion-inversion injury on a road march.  X-rays were normal, but an MRI showed findings of talar dome bone contusion and early stress fracture.  At the 30 June 2006 MEB NARSUM examination, 4 months prior to separation, the CI reported continued right ankle pain and felt she was unable to complete MOS training.  Physical examination showed an antalgic gait favoring the right lower extremity.  The CI was using one crutch for assistance.  There was no edema, erythema or ecchymosis.  Active range of motion (ROM) was dorsiflexion of 5 degrees and plantar flexion of 25 degrees with mild symptoms at the upper limits of all ranges.  There was tenderness over the anterior aspect of the right ankle with no crepitation or deformity.  During the 30 August 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the CI reported foot and ankle pain with difficulty ambulating due to pain and swelling.  Physical examination showed an antalgic gait and ankle edema.  The ROM evaluation showed dorsiflexion of -5 degrees and plantarflexion of 25 degrees.

At the 17 January 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported progressively worsening right ankle pain.  She used a brace and one crutch.  There was no laxity or weakness.  Physical examination showed an antalgic gait with swelling, effusion and tenderness.  Dorsiflexion was 10 degrees and plantar flexion was to 40 degrees with painful motion.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 10%, coded 5271 (limited motion of the ankle), citing moderate limitation of motion.  The VA also rated the right ankle condition 10%, coded 5271, based on the C&P examination, citing limitation of motion due to pain.  The panel considered if the limitation of motion was “moderate” or “marked” when considered under 5271, limitation of ankle motion.  All panel members agreed the limitation of motion was no more than “moderate,” therefore supporting the 10% rating adjudicated by the PEB.  A higher rating of 20% was not indicated in the absence of “marked” limited ROM of the ankle.  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.  

AR20190002382, XXXXXXXXXXXXXXXX 

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Dear XXXXXXXXXXXXXXXX:

	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.