RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-04246
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20080531

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Aircraft Communications Navigational Electrical Systems Technician, medically separated for “left ankle impingement” with a disability rating of 20%.

CI CONTENTION: Review requested of the unfitting left ankle as well as additional conditions (tinnitus and nightmares) 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 – 20080328	VARD – 20081128	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Ankle Anterior Impingement	5271	20%	
Left Ankle Osteoarthritis	
5010	
0%	
STR	
Left Ankle Chronic Instability…	Cat II					
Left Ankle Osteochondral Lesion of the Talus…	Cat II					
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 0%	

ANALYSIS SUMMARY:

Left Ankle Anterior Impingement. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent three left ankle surgical procedures to include: arthroscopic debridement of an anterior talar neck osteophyte in December 2005; arthroscopic debridement  and  drilling  of   a  small  osteochondral  lesion  of  the  lateral  talar  dome  on    12 December 2006; and a Brostrom ligament repair on 10 January 2007, after which he reported immediate  improvement  in  ankle stability.   He progressed  well until  October 2007  when  he

developed anterior left ankle pain. At the 28 January 2008 orthopedic surgeon follow-up, 4 months prior to separation, the CI reported pain about the anterior aspect of his ankle, but denied any episodes of instability. Physical examination revealed no tenderness, effusion, evidence of infection, or crepitus with motion. The calf was soft and non-tender without edema, but there was tenderness over the anteromedial and anterior aspect of the ankle. An X-ray showed no significant bony abnormalities and the OCD lesions appeared to have filled in.

The 11 March 2008 MEB NARSUM examination, 3 months before separation, noted CI complaints of severe sharp pain over the anterior medial aspect of the left ankle worsened by ankle dorsiflexion, stair climbing or walking on an incline, with an occasional catching sensation and stiffness in the morning. Physical examination revealed no swelling, but there was tenderness over the anterior medial and mid aspect of the ankle. There was no pain over the hind, mid or fore foot and the anterior drawer was intact. The left ankle range of motion (ROM) following repetition showed dorsiflexion of 10 degrees (normal 20) and plantar flexion of 15 degrees (normal 45). During the MEB examination (recorded on DD Forms 2807-1 and 2808) the next day, the CI reported constant ankle pain and swelling, and the examiner noted a history of osteoarthritis.  There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left ankle condition 20%, coded 5271 (limited motion of the ankle). The PEB listed “left ankle chronic instability; treated with Brostrom” and “left ankle osteochondral lesion of the talar treated with debridement and drilling” as Category II conditions (contribute to the unfitting condition but not separately ratable), and panel members agreed that these diagnoses could not 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 left ankle condition 0%, coded 5010 (arthritis due to trauma), based on the STR, citing a non-compensable evaluation assigned unless there is objective evidence of painful or limited motion of a major joint, or moderate limited motion of the ankle. The panel noted that the PEB assigned the maximum rating (20%) available under the diagnostic code 5271. Because there was no ankylosis, nonunion or malunion, VASRD §4.71a offers no other 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 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.

The following documentary evidence was considered:

2	PD-2017-05562

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

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) PDBRltr

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.