RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX		CASE: PD-2017-03829 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20080326

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Watercraft Engineer, medically separated for “chronic right ankle pain” with a disability rating of 20%.

CI CONTENTION:  No specific contention was made. 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 - 20080326	VARD - 20080425	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Ankle Pain	5271	20%	Status Post ORIF [Open Reduction Internal Fixation] Right Ankle Fracture	5262-5271	10%	20080211	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 80%	

ANALYSIS SUMMARY:

Chronic Right Ankle Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI had right ankle surgery in February 2007 to repair a bimalleolar fracture by an ORIF and placement of screws. Postoperatively, he developed a stitch abscess, which was removed, and then followed by extensive physical therapy (PT). During the 26 October 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, physical examination revealed right ankle edema with decreased range of motion (ROM) when rolling  the  ankle  in  adduction  (inward).    The  PT  evaluation  4  days  later  recorded  ROM as

dorsiflexion to 8 degrees (normal 20) and plantar flexion to 5 degrees (normal 45). Painful motion was not addressed, but mechanical limitation was noted to be capsular in nature with a firm end feel.

The 11 December 2007 MEB NARSUM examination, 4 months before separation, noted CI complaints of chronic right ankle pain exacerbated by prolonged standing, walking, or marching. Physical examination showed considerable swelling with +1 to +2 edema, but no superficial erythema or ecchymosis. He exhibited a limp, and right ankle dorsiflexion was to 0 degrees and plantar flexion to 20 degrees.

At the 11 February 2008 VA Compensation and Pension (C&P) examination, 2 months prior to separation, the CI reported constant right ankle weakness, and pain rated at 3/10. Physical examination showed a normal appearing ankle and gait. Right ankle dorsiflexion was to 20 degrees and plantar flexion to 30 degrees, with endpoint pain.

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 of). The VA rated the right ankle condition 10%, coded 5262-5271 (impairment of tibia & fibula-limited motion of ankle) based on the C&P examination, citing evidence of painful limitation of motion. Panel members noted that the PEB assigned the maximum rating (20%) available under the diagnostic code 5271. Because there was no ankylosis of the ankle or subastragalar (sub-tarsal) joints, no malunion of the os calcis (calcaneus) or astragalus (talus), and no astragalectomy for consideration under the respective diagnostic codes (5270, 5272, 5273 or 5274), VASRD §4.71a offers no other rating options which would yield a rating higher than the 20% rating adjudicated by the PEB. 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 pain.

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.

PD-2017-03829 

AR20190010946, XXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXX

	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.

PD-2017-03829