RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXX	CASE: PD-2017-04049
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20070302

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Fire Controlman, medically separated for “chronic tenosynovitis” with a disability rating of 0%.

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 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 - 20061129	VARD - 20071011	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Tenosynovitis	5099-5003	0%	Tendinitis, Right Ankle	5271-5024	10%	20070605	
Right Peroneal Tendon Injury	Cat II					
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Chronic Tenosynovitis. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right peroneal tendon repair on 28 March 2006 due to a longitudinal tear in the peroneus brevis tendon tear. Surgery provided only mild improvement in symptoms. Other treatment consisted of ankle bracing, orthotics, injection, nonsteroidal anti- inflammatory medication and physical therapy. MRI studies on 28 September 2006 were consistent with tenosynovitis.

The 26 October 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of daily pain aggravated by weight bearing activities. Physical examination showed tenderness over the peroneal tendons. Range of motion (ROM) in the right ankle showed dorsiflexion of 10 degrees (normal 20) and plantar flexion with 25 degrees (normal 45). The CI was able to perform a heel raise. During the MEB examination (recorded on DD Forms 2807-1 and 2808), 5 days later, the CI reported difficulties with prolonged ambulation. Physical examination revealed tenderness, pain with inversion and eversion, but full ROM. The CI walked with a slight limp.

At the 5 June 2007 VA Joint Compensation and Pension (C&P) examination, 3 months after separation, the CI reported pain and decreased ROM. Physical examination findings included tenderness over the posterior talo fibular and painful movement. Right ankle dorsiflexion was 15 degrees and plantar flexion was 40 degrees with objective evidence of painful motion. There was no additional limitation after three repetitions.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right ankle condition 0%, analogously coded 5099-5003 (degenerative arthritis). The PEB listed right peroneal tendon injury as a related Category II condition contributing to the disability in the case. The panel concluded the Category II diagnosis was not a separate condition which could be reasonably justified as separately unfitting; nor would separate ratings be achievable without violation of VASRD §4.14 (avoidance of pyramiding). The VA rated the right ankle condition 10%, analogously coded 5271-5024 (limited motion of the ankle-tenosynovitis) based on the C&P examination, citing painful or limited motion of a major joint or group of minor joints.

The panel agreed that the ROM examinations proximate to separation were consistent with the “moderate” limitation of motion required for a 10% rating under code 5271. There was evidence of painful motion causing functional loss supporting the 10% rating (based on §§4.40, 4.45 and 4.59). Because there was no ankylosis (5270), nonunion or malunion (5262), VASRD §4.71a offers no applicable joint code which would yield a higher rating. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right ankle condition, coded 5271.

BOARD FINDINGS: In the matter of the right ankle condition, the panel recommends a disability rating of 10%, coded 5271 IAW VASRD §4.71a. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Tenosynovitis (Right Ankle)	5271	10%	

2	PD-2017-04049

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 REFE.q TO:
1850
CORB:003
12 Oct 20

From: To:
Subj:

Ref:

Director, Secretary of the Navy Council of Review Boards

PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)
(a) DoDI 6040.44
(b)	PDBR ltr of 26 Feb 20
(b)	

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy for appropriate action.

2.	On 7 October 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) took action in your case by accepting the recommendation of the PDBR. Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEB) from 0% to 10% without re-characterization of your discharge.

3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, has been forwarded to the Navy Personnel Command for appropriate changes to your personnel records and notification to you upon completion.