RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-03163
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20080809

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Electrical/Mechanical Equipment Repairman, medically separated for “[right] ankle instability” and “[right ankle] pain,” rated 10% each, with a combined disability rating of 20%.

CI CONTENTION: “This has changed my life forever, I will never be the same physically and mentally.”  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 - 20080403	VARD - 20090708	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Ankle Instability	8627	10%	Right Ankle Strain S/P Reduction and Internal Repair	5271-5262	20%	20090204	
Right Ankle Pain	5299-5003	10%					
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 40%	
	
ANALYSIS SUMMARY:

Right Ankle Instability, Status Post (S/P) Procedure with Continued Pain. According to the service treatment record and the MEB narrative summary (NARSUM), the CI underwent right ankle surgery in August 2006 for ankle stabilization (portion of the peroneal tendon was used to weave into the distal fibula). Despite multiple bouts of physical therapy (PT), the condition continued to worsen.  An MRI in October 2007 revealed postoperative changes in

the distal fibula, chronic anterior talofibular ligament tear and 0.9 cm osteochondral deformity of the talar dome, not clearly detached.

The 14 January 2008 MEB NARSUM examination, 7 months prior to separation, noted complaints of right ankle pain and swelling. The CI was unable to run without pain and it hurt to wear boots. He could not swim for the fitness test. Physical examination of the right ankle showed tenderness of the surgical scar at the distal end, but no tenderness along the joint line of the ankle. The ankle was stable to talar tilt and anterior drawer. Range of motion (ROM) testing showed 10 degrees  of  dorsiflexion  (normal  20)  and  60  degrees  of  plantar  flexion  (normal  45).  The  26 February 2008 addendum to the MEB indicated no change in the CI’s condition since the NARSUM.

At the 4 February 2009 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported daily right ankle pain with weakness, stiffness, swelling popping, fatigue and lack of endurance but no locking. He was able to walk up to 3 miles without pain. Physical examination showed a tender scar, but it was well healed, not adherent and not depressed. Right ankle ROM testing showed 10 degrees of dorsiflexion, and 40 degrees of plantar flexion. There was no evidence of ankle instability (no ligament laxity). There was no additional loss of ROM due to pain on repetitive use. There was evidence of mild fatigability, weakness and lack of endurance but no incoordination of the right ankle. Right ankle X-ray showed a talofibular ligament repair suture and bone demineralization of the right distal fibula, but no current evidence of post-traumatic degenerative joint disease.

The panel directed attention to its rating recommendation based on the above evidence. The PEB dual rated the ankle condition as follows: 10%, coded 8627 (neuritis); and 10%, analogously coded 5099-5003 (arthritis, degenerative), for a combined rating of 20%. The VA rated the right ankle strain S/P reduction and internal repair condition 20%, dual coded 5271-5262 (limited motion of ankle due to impairment of tibia and fibula), based on the C&P examination. The panel noted the 10% rating is the highest rating available under the 8627 code. The panel also noted a higher rating was not achievable under the diagnostic code 5271, limitation of ankle motion. The panel considered the 5262 (tibia and fibula, impairment of) code, and concluded, although it was an appropriate code, it offered no rating benefit to the CI. There were no alternative VASRD ankle or analogous codes that would support a rating higher than the PEB’s combined 20% 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:

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 dtd 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 ofno 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