RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2017-02900
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050112

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an E5, Motor Transport Operator, medically separated for “traumatic osteoarthritis right ankle” with a disability rating of 10%.  

CI CONTENTION:  “The VA provided a higher rating for my ankle condition.”  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 - 20041021	VARD - 20050110	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Traumatic Osteoarthritis Right Ankle	5271	10%	Traumatic Arthritis, Right Ankle Postoperative	5271-5010	10%	20041210	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Traumatic Osteoarthritis Right Ankle.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent open reduction internal fixation (ORIF) with subsequent hardware removal 5 years before entering the Service.  He entered the service in 1995 and developed post traumatic arthritis that was exacerbated by multiple sprains.  Right ankle arthroscopy was performed on 1 September 2004 with findings of a global Grade II chondromalacia of the tibial talar joint and extensive synovitis.  Radiographic studies showed early Fairbanks changes with joint space narrowing and modest marginal osteophytosis.  

During the 28 September 2004 MEB NARSUM examination, 3 months prior to separation, the CI reported persistent right ankle effusions and post-operative tenderness but had slightly improved range of motion (ROM).  The examiner informed the CI that he had not yet reached maximal recovery from his extensive arthroscopic debridement done less than a month prior to the examination.  Physical examination revealed “a trace effusion” and moderate swelling around both arthroscopic portal sites with tenderness.  The ankle ligaments were stable and right ankle ROM measurements showed dorsiflexion of 10 degrees (normal 20) and plantar flexion of 20 degrees (normal 45).  Right ankle X-rays in November 2004 revealed a bony fragment anterior to the distal right tibia that had the appearance of an old avulsion of the distal tibia; however, the examiner noted that the possibility of an acute small avulsion fracture could not be definitively ruled out.  The bony structures of both ankles were otherwise intact with no further evidence of fracture or dislocation.  

At the 10 December 2004 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported use of an ankle support when participating in strenuous activities.  Physical examination showed normal gait, posture and balance.  The right ankle appeared to be “slightly larger” than his left ankle.  There was no tenderness and the CI was able to rise on heels and toes, walk heel-to-toe, and stand on one foot without evidence of discomfort.  Right ankle ROM testing showed dorsiflexion of 30 degrees and plantar flexion of 20 degrees with pain.  There was no evidence of sensory or motor impairment.  

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%, dual coded 5271-5010 (limitation of motion due to traumatic arthritis), based on the C&P examination, citing painful or limited motion of a major joint.  The panel considered if the limitation of motion was “moderate” or “marked” when considered under VASRD code 5271.  The panel agreed that the ROM examinations proximate to separation supported no greater than the “moderate” (10%) level of limitation, and there was also evidence of painful motion (VASRD §4.59) supporting an alternate rating of 10%.  Because there was no ankylosis, nonunion or malunion, VASRD §4.71a offered no applicable joint code which would yield a rating higher than the 10% rating adjudicated by the PEB.  The panel also considered alternative VASRD ankle and analogous codes, but all were less applicable and/or not advantageous to rating.  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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170317, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

		PD-2017-02900

AR20190009887, XXXXXXXXXXXXXXX

Dear XXXXXXXX

	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.

	PD-2017-02900