RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-03778 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20090330

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Helicopter Crew Chief, medically separated for “post- traumatic arthritis left ankle ” with a disability rating of 10%.

CI CONTENTION: “This was a career ending injury and I haven’t been able to run since it happened. Despite limited PT and 2 combat deployments after my injury the Marines decided they didn’t need me anymore.”  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 – 20081218	VARD – 20091006	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Post-Traumatic Arthritis Left Ankle	5099-5003	10%	Traumatic Arthritis with Tendinitis of Left Ankle…	5271	10%	20090508	
Peroneal Tendonitis	Cat II	See 5271 Above	
Status Post, Open Reduction Internal Fixation…	Cat II		
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Left Ankle Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI sustained a left ankle fracture-dislocation (mid and distal fibula) while playing football during physical training in August 2005.  He required emergent surgery, and in 2006, he

underwent hardware removal. Despite extensive post-operative rehabilitation, he continued to experience left ankle pain.

The 18 November 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of left ankle pain rated at 7/10, 3 to 4 times a week. Physical examination revealed tenderness over the peroneal tendon with weakness on eversion. There was a large osteophyte at the anterior talar neck and global edema about the foot with a positive impingement sign. Single leg stance was poor and he was unable to hop on either leg. The examiner noted left ankle range of motion (ROM) with dorsiflexion (DF) of 10 degrees (normal 20) and plantar flexion (PF) of 35 degrees (normal 45). He was able to toe and heel walk without difficulty and had a normal reciprocal gait.

At the 6 October 2009 VA Compensation and Pension (C&P) examination, 7 months after separation, the CI reported left ankle pain. Physical examination revealed an antalgic gait without use of an assistive device to ambulate. The left ankle mortise was preserved with hypertrophy  of the superior portion of the talus but no evidence of soft tissue swelling. Dorsiflexion was to 20 degrees and PF to 30 degrees, with pain, but no ROM decrease after repetitive motion. An X- ray revealed no fracture or dislocation.

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. It is first clarified that the Category II diagnoses (“peroneal tendonitis” and “status post, open reduction internal fixation of ankle fracture”) are intrinsic to the rated condition and separate ratings cannot be supported without pyramiding (VASRD §4.14); thus, they are appropriately subsumed under the same rating. The VA also rated the left ankle condition 10%, but analogously coded 5271 (ankle, limited motion of), based on the C&P examination, citing limited painful motion of the ankle. Panel members agreed that the limitation of motion of the left ankle was no more than “moderate,” supporting a 10% rating under code 5271. A higher 20% rating was not indicated in the absence of “marked” limited ankle ROM. The panel considered other ankle and fibular codes, but all were less applicable or not advantageous for 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 left ankle condition.

BOARD FINDINGS: In the matter of the left ankle condition, including the Category II conditions, 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 <ltd 25 Jul 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