RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX  	CASE:  PD-2017-03402
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20080404

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Ground Radio Communication Apprentice, medically separated for “left ankle pain” 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 - 20080212	VARD - 20081030	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Ankle Pain	5099-5003	10%	Residuals of Left Ankle Non-Displaced Fracture 	5311-5271	10%	20080709	
COMBINED RATING:  10%	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 around August 2006 without specific injury, but after extended running.  X-rays were normal.  At the time of the orthopedic clinic appointment on 30 November 2007, 4 months prior to separation, the CI reported sensitivity along the inside part of his ankle and his pain was 8/10.  On examination there was mild swelling, but no instability.  Range of motion (ROM) was normal.  An MRI in December 2007 revealed a partial tear of the peroneus brevis and longus tendons.  The 20 December 2007 MEB NARSUM examination, 3 months prior to separation, noted complaints of pain to his left ankle.  Physical examination showed tenderness, but no laxity, edema, erythema or warmth.  ROM was “full.”  

At the 9 July 2008 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported aching and sharp 5/10 ankle pain elicited by physical activity.  Physical examination showed a normal gait.  There was tenderness, but no laxity, edema, erythema or warmth.  Left ankle ROM testing showed dorsiflexion of 20 degrees (normal) and plantar flexion of 45 degrees (normal).  The joint function was not additionally limited by pain, fatigue, weakness, lack of endurance or incoordination after repetitive use.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left ankle condition 10%, analogously coded 5099-5003 (degenerative arthritis).  The VA also rated the left ankle condition 10%, dual coded 5311-5271 (muscle group 11 function - limited motion of ankle) based on the C&P examination, citing painful or limited motion of a major joint or group of minor joints.  

There was no limitation of dorsiflexion or plantar flexion that supported a rating under the VASRD diagnostic code for limitation of motion (5271).  However there was evidence of painful motion causing functional loss supporting a 10% rating based on §4.59, §4.40 and §4.45.  The panel considered alternative VASRD ankle and analogous codes, but all were less applicable and/or not advantageous to rating.  After due deliberation, considering all of 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.  

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

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Dear XXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-03402.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.