RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX		CASE: PD-2017-01616 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20080109

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Armor Crewman, medically separated for “chronic right ankle pain” with a disability rating of 0%.

CI CONTENTION: “I have a metal bur and 6 screws in my ankle therefore I feel the 0% rating is unjust.  I feel constant pain.”  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 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 - 20080109	VARD - 20080512	
Condition	Code	Rating	Condition	Code	Rating	Exam	

Chronic Right Ankle Pain	
5099-5003	
0%	Right Ankle Tendonitis Status Post-Operative Repair of an Osteochondral Lesion of Right Talar Done	
5024	
10%	
20080229	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Chronic Right Ankle Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent a right talar dome repair 22 March 2007. The CI continued to report stiffness, weakness, and ankle pain. The 9 November 2007 MEB NARSUM examination, 2 months prior to separation, noted complaints of 2/10 pain and stiffness. Pain increased to 6-7/10 with activity. Physical examination revealed lateral ankle tenderness, dorsiflexion to 10 degrees (normal 20), limited by pain, and plantar flexion to 30 degrees (normal 45), limited by pain.

At the 29 February 2008 VA Compensation and Pension (C&P) examination, one month after separation, the CI reported right ankle pain aggravated by physical activity. Physical examination showed tenderness. Dorsiflexion and plantar flexion were normal and pain-free. The joint was not additionally limited by pain, fatigue, weakness, and lack of endurance after repetitive use.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right ankle condition 0%, analogously coded 5003 (degenerative arthritis), citing slight loss of ankle motion due to pain alone, not mechanical factors. The VA rated the right ankle tendonitis condition 10%, coded 5024 (tenosynovitis), based on the C&P examination, citing painful or limited motion of a major joint or group of minor joint.

There was no limitation of dorsiflexion or plantar flexion that supported a rating under the VASRD diagnostic code for limitation of motion (5271). However there was evidence of painful motion causing functional loss supporting the 10% rating (based on §§4.59, 4.40 and 4.45). After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the chronic ankle condition, coded 5299-5003.

BOARD FINDINGS: In the matter of the chronic ankle condition, the panel recommends a disability rating of 10%, analogous coded 5099-5003 IAW VASRD §4.71. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Right Ankle Pain	5099-5003	10%	

AR20190013198, XXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXX

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 Affairs.