NAME:  XXXXXXXXXXXX

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

CASE: PD-2017-03040

BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060603

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

CI CONTENTION:  Review all conditions.  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 - 20060225	VARD - 20070212	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Ankle Pain	5099-5003	10%	Status Post Right Ankle Strain	5271	10%	20061222	
Plantar Fasciitis, Resolved	Not Unfitting	No VA Placement	
Flexible Pes Planus			
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	
	
ANALYSIS SUMMARY:

Chronic Right Ankle Pain. According to the service treatment record (STR) and the MEB narrative summary (NARSUM), the CI underwent right ankle surgery (modified Brostrom) in November 2004. He continued to have instability issues after removing the postoperative ankle boot, with recurrent strains, sprains and swelling. Radiographic studies revealed some mild degenerative changes at the dorsum of the talus. At the podiatry clinic visit on 3 November 2005, 7 months prior to separation, the CI complained of 3/10 right ankle pain and swelling without instability. Physical examination revealed an antalgic gait and abnormal appearance of the ankle with weakness, swelling and tenderness of the posterolateral aspect. However, range of motion (ROM) was normal and provocative testing for instability was negative.

The 13 December 2005 MEB NARSUM examination, 6 months prior to separation, noted complaints of ankle swelling and pain. Physical examination showed the CI walked with a slight antalgic  gait,  but   ROM   was   “essentially”  full  with   some  limitation  in   dorsiflexion.     The

29 December 2005 MEB ROM study showed, after three repetitions, pain-limited dorsiflexion of 10 degrees (normal 20) and plantar flexion of 51 degrees (normal 45).

At the 22 December 2006 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported a painful but stable right ankle. There were flare-ups and swelling with use, but the CI denied loss of motion. Physical examination showed normal ROM and gait with no mention of pain, but some instability.  Radiographic results were negative.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right ankle condition 10%, analogously coded 5003 (arthritis, degenerative), citing slight and constant pain IAW the US Army Physical Disability Agency pain policy. The VA rated the right ankle condition 10%, coded 5271 (ankle limitation of motion), based on the C&P examination, citing moderate limitation of motion of the ankle. Given the absence of ankylosis or fracture, there was only one applicable joint code (5271) which would yield a rating higher than the PEB’s 10%; however, the 20% rating under 5271 for “marked” limitation of motion was not supported by the ROM evidence. 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.

Contended PEB Conditions: Plantar Fasciitis and Flexible Pes Planus. The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting. Neither one of the conditions was profiled, implicated in the commander’s statement or noted to fail retention standards. There was no performance-based evidence from the record that either of the conditions 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 either of the contended conditions, so no additional disability ratings are recommended.

BOARD FINDINGS: In the matter of the right ankle condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication. In the matter of the contended plantar fasciitis and flexible pes planus, the panel recommends no change from the PEB determination as not unfitting. 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:

2	PD-2017-03040

[AR NUMBER],

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.

Enclosure