RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01542
BRANCH OF SERVICE:  ARMY	SEPARATION DATE:  20090211

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Ammunition Specialist, medically separated for “right ankle pain” with a disability rating of 10%.

CI CONTENTION:  The CI made no specific contention.  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 - 20081104	VARD - 20090427	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Ankle Pain	5271	10%	Chronic Mild Synovitis, Right Ankle	5020-5271	10%	20090210	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Right Ankle Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right ankle arthroscopic synovial and tibial spur debridement in February 2008.  During the 28 May 2008 orthopedic clinic appointment, 3 months post-surgery and 9 months before separation, the CI reported return of right ankle pain.  Physical examination showed ankle tenderness and range of motion of dorsiflexion to 5 degrees (normal 20) and plantar flexion to 45 degrees (normal); painful motion was not addressed.  The 19 August 2008 MEB physical therapy evaluation, 6 months before separation, revealed a normal gait.  Repetitive ROM was dorsiflexion to 10 degrees and plantar flexion to 30 degrees; painful motion was absent.  
At the 8 September 2008 MEB NARSUM examination, 5 months before separation, noted complaints of right ankle pain aggravated by climbing stairs, moving it the wrong way, running, jumping or sitting with her right leg crossed on the left.  Physical examination showed a normal gait with right ankle tenderness to palpation but no deformity, edema, erythema or warmth.  

At the 10 February 2009 VA Compensation and Pension (C&P) examination, 1 day before separation, the CI reported right ankle pain with weekly flare-ups.  Physical examination showed a normal gait.  There was right ankle swelling, tenderness and weakness, but no ankle instability.  Dorsiflexion was 15 degrees and plantar flexion was 30 degrees; painful motion was present.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 10%, coded 5271 (ankle, limitation of motion), citing moderate ankle injury and functional loss.  The VA also rated the right ankle condition 10%, coded 5020-5271, (synovitis-ankle, limitation of motion), based on the C&P examination, citing painful and moderate limitation of motion.

The panel considered if the limitation of motion was “moderate” or “marked” when considered under 5271, limitation of ankle motion.  The panel agreed that the ROM examinations proximate to separation were consistent with the “moderate” limitation of motion required for the 10% rating under this code.  There was no ankylosis of the ankle or subastragalar (sub-tarsal) joints, no malunion of the os calcis (calcaneus) or astragalus (talus), and no astragalectomy for consideration under the respective diagnostic codes (5270, 5272, 5273 or 5274).  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 20170227, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180007945, 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