RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01765
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050130

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Finance Senior Sergeant, medically separated for left Achilles tendon pain with a disability rating of 20%.  

CI CONTENTION:  “I had a herniated disk, shaving profile, Achilles tendon repair/scare, broken wrist (right), shoulder (right) pain from herniated disk in neck.”  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 - 20041201	VARD - 20050317	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Achilles Tendon Rupture 	5271	20%	Achilles Tendon Rupture, Left Ankle	5299-5271	20%	STR	
Herniated Disk, Neck	Not Unfitting	Degenerative Disk Disease	5243	0	STR	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:

Achilles Tendon Rupture.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s left Achilles condition began in October 2003 during a flag football game.  The CI underwent left Achilles tendon repair in November 2003.  The CI out-processed and had a permanent change of station immediately after the operation and was not enrolled in physical therapy until 4 months after the operation.  The 31 August 2004 MEB NARSUM examination, 4 months prior to separation, noted complaints of pain that worsened with prolonged standing; walking more than 2 miles; and running, jumping, or marching greater than 1 mile.  Physical examination showed the left ankle with a healed incision over the Achilles tendon.  Ankle range of motion revealed dorsiflexion to neutral (normal 20 degrees) and plantar flexion of 10 degrees (normal 45).  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left Achilles tendon condition 20%, coded 5271 (ankle, limited motion), citing marked limitation of motion.  The VA also rated the left Achilles tendon condition 20%, coded 5299-5271 (analogous to ankle, limited motion), based on the STR, citing a tender Achilles tendon with dorsiflexion to neutral position and plantar flexion to 10 degrees with gastroc-soleus complex strength measured at 4 out of 5.  The panel noted that the PEB adjudicated the maximum rating using code 5271.  There was no evidence of ankle ankylosis to provide a higher rating under code 5270.  There was no VASRD §4.71a route to a higher rating than the one adjudicated by the PEB.  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 left Achilles condition.  

Contended PEB Condition:  Herniated disk, neck.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was not profiled, implicated in the commander’s statement, nor judged to fail retention standards.  The neck condition was treated in October 2003 with traction which provided good relief and there were no other complaints of neck pain prior to separation.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the left Achilles tendon condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended herniated disk condition, the panel agrees that it cannot recommend it for additional disability rating.  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 20170208, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180005845, 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