RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04012
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070621

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Military Policeman, medically separated for “right ankle pain” with a disability rating of 10%.  

CI CONTENTION:  Requested review of 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 - 20070509	VARD - 20080624	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Ankle Pain	5271	10%	Right Ankle Status Post Ligament Tear…	5271	10%	20080513	
High Cholesterol and Triglycerides	Not Unfitting	Hypertension	7101	0%	20080513	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Right Ankle Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right ankle arthroscopic surgery in February 2006 for lateral ligament reconstruction and medial malleolar debridement.  Subsequent X-rays and MRI documented arthritic changes and ligament damage.  At the time of the orthopedic clinic appointment on 10 January 2007, 5 months prior to separation, the CI reported fairly constant right ankle pain, rated at 3-4/10, that flared to 9/10 when he tried to run or stand for over 20 minutes, or when walking for more than half a mile.  On examination, the CI’s gait was normal and right ankle surgical scars were well-healed.  The foot arches were normal, drawer testing laxity was negative, and sensation and motor functions were intact.  Right ankle range of motion (ROM), after repetition, showed dorsiflexion of 5 degrees (normal 20) and plantar flexion of 35 degrees (normal 45).  

During the 22 January 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported right ankle pain and limited ROM.  The examiner noted mild pain on the medial aspect of the ankle next to the scar as well as pain with ROM.  The 2 February 2007 MEB NARSUM examination noted complaints of right ankle pain described as sharp with activity, and dull and constant (4/10) in the morning, but improved somewhat after walking.  The pain was worse with activities like walking for more than 30 minutes, running, biking, climbing stairs, or swimming.  Physical examination showed a normal gait and no swelling, foot discoloration, bony deformity, flat foot or guarding.  Right ankle ROM was full with mild pain during ankle rotation and no excessive ankle pronation.  Motor function was normal.  

At the 13 May 2008 VA Compensation and Pension (C&P) examination, 11 months after separation, the CI reported daily right ankle pain, rated at 4-9/10.  Standing and walking long distances provoked this pain, and he felt ankle weakness and stiffness but no giving way or locking  He used an ankle brace at times, but the ankle pain did not incapacitate him from work.  Physical examination showed an antalgic gait and adherent, tender scars, but no evidence of deformity, effusion or crepitus.   Right ankle ROM showed dorsiflexion of 15 degrees and plantar flexion of 30 degrees, and muscle strength at 5/5.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 10%, coded 5271 (ankle, limited motion of), citing limitation of motion.  The VA also rated the right ankle condition 10%, coded 5271, based on the C&P examination, citing moderate, limited ankle motion.  Upon deliberation, panel members agreed the limitation of motion was no more than “moderate,” therefore supporting the 10% rating adjudicated by the PEB.  A higher 20% rating was not indicated in the absence of “marked” limited ankle ROM.  Because there was no ankylosis, nonunion or malunion, VASRD §4.71a offers no applicable joint code warranting a rating higher than 10%.  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:  High Cholesterol and Triglycerides.  The panel’s main charge is to assess the fairness of the PEB determination that the contended high cholesterol and triglycerides condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement, and did not 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 condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended high cholesterol and triglycerides, 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-2017-04012

AR20190012017, XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXX

	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-2017-04012