RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03201
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20081118

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, AH-64D Armament/Electronic/Avionic System Repairer, medically separated for “right ankle pain” with a disability rating of 20%.  

CI CONTENTION:  He requested “review all conditions” as well as additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20080724	VARD - 20090528	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Ankle Pain Status Post Brostrom Procedure	5271	20%	Right Ankle Degenerative Changes, Status Post Reconstructive Surgery 	5271-5003	0%	20090406	
Cervicalgia	Not Unfitting	Cervicalgia	5299-5237	NSC	20090406	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Right Ankle Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right ankle pain began in January 2007 when he stepped into a hole, rolled his ankle and heard a pop.  He again rolled his ankle twice during the Special Forces selection process in April 2007 and underwent surgical repair (Brostrom procedure) in October 2007.  

The 1 April 2008 MEB physical therapy (PT) examination, 8 months prior to separation, noted right ankle dorsiflexion to -5 degrees (normal 20) and plantar flexion to 30 degrees (normal 45); painful motion was present.  During the 13 May 2008 MEB NARSUM examination, 6 months before separation, the CI reported constant right ankle pain aggravated by prolonged walking and standing, pivoting, and running.  The examiner referenced the MEB PT ROMs.  The 6 and 11 June 2008 orthopedic examinations, 5 months prior to separation, recorded right ankle dorsiflexion to “neutral” (0 degrees) and plantar flexion to 30 degrees with no pain reproduced during “flexion extension” and negative impingement testing.  At the 6 April 2009 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported that he could not run and was limited to walking one mile due to right ankle pain. Dorsiflexion was 20 degrees and plantar flexion was 45 degrees, with no painful motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 20%, coded 5271 (ankle, limited motion), citing “marked” limitation of motion.  The VA rated the right ankle condition 0%, dual coded 5271-5003 (ankle, limited motion-arthritis, degenerative), based on the C&P examination, citing a noncompensable evaluation.  Members agreed that the MEB PT and orthopedic ROM measurements proximate to separation were consistent with the “marked” limitation of motion required for the maximum 20% rating under code 5271.  The panel considered alternative VASRD ankle 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.  

Contended PEB Condition:  Cervicalgia.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not profiled, implicated in the commander’s statement nor judged to fail retention standards.  There was no performance-based evidence from the record that the condition 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 the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the right ankle pain and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended cervicalgia condition, the panel agrees it cannot recommend it for additional disability rating.  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 20170323, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180012270, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	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.

Sincerely,					      

Enclosure