RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-03147 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20070731

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Rifleman, medically separated for “chronic [left] ankle pain and instability” 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’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 - 20070626	VARD - 20071212	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Ankle Pain and Instability	5099-5003	10%	Left Ankle Injury, Status Post S/P Arthroscopy	5271	10%	20071003	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Chronic Left Ankle Pain and Instability. According to the service treatment record and MEB narrative summary (NARSUM), the CI twisted his left ankle while descending a flight of stairs in March 2006. X-rays showed medial and anterior osteophytes.  An MRI in August 2006 revealed a possible tear of the calcaneofibular and anterior talofibular ligaments. In October 2006, the CI underwent surgery to remove the osteophytes. At the time of the sports medicine clinic appointment on 16 January 2007, 6 months prior to separation, and 3 months post- surgery, the CI reported doing well.  He had full left ankle ROM and a normal neurological examination.

The 9 May 2007 MEB NARSUM, 3 months prior to separation, noted 2-6/10 left ankle pain that was aggravated by running and physical activity. Physical examination noted the CI was in no acute distress. There was tenderness of the left ankle anteriorly and laterally. Pain was elicited with motion. There was no swelling, warmth or deformity present. The CI had full left ankle ROM, negative anterior drawer signs and negative talar tilt, but there was weakness noted with plantar flexion of the left ankle.  He was unable to perform a single leg hop on his left leg.

At the 3 October 2007 VA Compensation and Pension (C&P) joints examination, 2 months after separation, the CI reported pain, aching, soreness and tenderness of the left ankle. He reported intermittent use of a brace for his left ankle. He was able to do his normal job and normal daily activities. The ROM examination showed left ankle dorsiflexion of 10 degrees (normal 20) and plantar flexion of 40 degrees (normal 45) with pain at the extremes of motion. Repetitive use did not cause increased pain or decreased ROM. The examiner stated “the left ankle does show a little bit of lateral instability,” but did not elaborate further.
The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left ankle condition 10%, analogously coded 5009-5003 (degenerative arthritis). The VA rated the left ankle condition 10%, coded 5271 (limited motion of the ankle), citing moderate limitation of motion. The panel considered a rating for limitation of motion under code 5271, but agreed the pre-separation NARSUM examination, which showed full ROM, did not support the minimal 10% rating under this code. However, the post-separation VA examination was consistent with “moderate” limitation of motion and supported a 10% rating. Alternatively, there was evidence of painful motion with functional loss on both the NARSUM and VA C&P examinations, which supported a 10% rating based on §4.59, §4.40 and §4.45. The panel also considered the 5262 (tibia and fibula, impairment of) code but there was no evidence of non- union or malunion to support a rating under this code. 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 left ankle condition.

BOARD FINDINGS: In the matter of the left 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:

2	PD-2017-03147

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    REPLY   REFER  TO:
1850
CORB: 003 20May20

From: 

Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL DISABILITY  BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr <ltd 14 May 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate  action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation  Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.

Copy to: PDBR