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DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD DC 20374-5023

IN R[PL'I  REFER TO

1850
CORB:003
27 Feb 20

From:
To:

Director, Secretary of the Navy Council of Review  Boards
PD-2017-03037

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)
Ref:	(a) DoDI 6040.44
lb) PDBR ltr of 1 May 19
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its
recommendation to the Department of the Navy for appropriate  action.

2.	On 21 February 2020, the Assistant General Counsel of the Navy (Manpower & Reserve  Affairs)  took action  in  your  case by    accepting  the recommendation of the PDBR.	Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEB) from 0% to 10% without re-characterization of your discharge.
3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	The Assistant Secretary's determination, which represents  final action in  your case by the Department of the Navy, has been forwarded to the Navy Personnel Command for appropriate changes to your personnel records and notification to you upon completion.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE: PD-2017-03037 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20050815

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Construction Electrician, medically separated for “left ankle pain” with a disability rating of 0%.

CI  CONTENTION:	“Because  I’m  still  having  problem[s]  with   [my]  injury.”	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 - 20050701	VARD - 20060104	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Ankle Pain	5299-5003	0%	Residuals of Left Ankle Sprain	5271	10%	20050729	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Left Ankle Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left ankle condition began in March 2003 after a rollover injury which occurred during physical training. The 17 August 2004 orthopedic examination, 12 months before separation, recorded full left ankle range of motion (ROM), and negative anterior/posterior drawer test. Motor strength was 5/5, but there was tenderness over the anterior ligaments. At the physical therapy clinic appointment on 24 August 2004, the CI reported left ankle pain. On examination the CI walked with a slow guarding gait. Strength was 5/5 with plantar flexion and inversion.  There was tenderness to bilateral lateral malleolis.   Left

ankle ROM showed dorsiflexion of 15 degrees (normal 20) and plantar flexion of 50 degrees (normal 45).  Painful motion was noted with dorsiflexion and eversion.

The 2 June 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of left ankle pain. The CI stated he couldn’t run at all, could only walk about 15 minutes at a time, and could only stand for about 10 minutes without significant foot and ankle pain. The examiner opined that the maximum benefit of treatment had been obtained and the CI wouldn’t likely be able to perform his military duties as required or perform his physical fitness test runs.

At the 29 July 2005 VA Compensation and Pension (C&P) examination, one month before separation, the CI reported left ankle pain (7/10) and stated the left ankle was weak, stiff, swelled, gave way, and didn’t lock but was easily fatigued. Physical examination showed the CI’s gait was normal. Left ankle ROM showed dorsiflexion of 0 degrees and plantar flexion of 65 degrees. There was no pain, crepitation, or change in ROM with repetitive activity due to pain, fatigue, weakness, or lack of endurance. Same-day X-rays revealed small ossific density seen in the inferior aspect of the distal fibula most compatible with an old avulsion injury. There was no evidence of acute fracture or dislocation and no evidence of acute osseous injury involving the left ankle.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left ankle condition 0%, analogously coded 5003 (degenerative arthritis). The VA rated the left ankle condition 10%, coded 5271 (ankle, limited motion), based on the C&P examination, citing dorsiflexion was to 5/20 degrees and restriction was characterized as moderate. Panel members agreed the evidence supports a 10% rating IAW §§VASRD 4.40, 4.45, and 4.59, based on limitation of motion and functional loss due to pain and excess fatigability. Panel members also agreed that the C&P ROM examination proximate to separation was consistent with the “moderate” limitation of motion required for the 10% rating under the 5271 code. The panel considered the higher rating of 20% for “marked” limitation, but concluded that the degree of impairment was not supported by radiological and clinical evidence. There was no ankylosis (5270), or nonunion or malunion (5262) to support a higher rating. 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 left ankle condition, coded 5299-5003.

BOARD FINDINGS: In the matter of the left ankle condition, the panel recommends a disability rating of 10% coded 5299-5003 IAW VASRD §4.71a. 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	
Left Ankle Pain	5299-5003	10%	

The following documentary evidence was considered: