RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXX	CASE: PD-2017-04390
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20050831

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E3, Intelligence Specialist, medically separated for “left ankle bimalleolar fracture” with a disability rating of 10%.

CI CONTENTION: A review of all conditions was requested in addition to a 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 – 20050628	VARD - 20060517	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Ankle Bimalleolar Fracture	5271	10%	S/P Left Fibular and Ankle Fracture with Retained Hardware	5271-5262	30%	20050819	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Left Ankle Bimalleolar Fracture. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent left ankle open reduction and internal fixation (ORIF) on 10 August 2004 following an injury resulting in a bimalleolar ankle fracture (fibular fracture above the ankle and medial malleolar fracture, Weber Type C). He was followed by orthopedics with limited weight bearing activities until he underwent syndesmosis screw removal on 28 December 2004.The 6 April 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of aching pains and stiffness especially in the morning. He could not perform any

impact activities or walk on uneven terrain. Physical examination showed mild diffuse swelling about the ankle. Range of motion (ROM) was dorsiflexion to neutral or 0 degrees (normal 20) and plantar flexion of 30 degrees (normal 45).

At the time of the sports medicine clinic appointment on 25 April 2005, 4 months prior to separation, the CI reported he was working 8 hours a day on his feet and had sharp shooting pain. On examination there was tenderness to the distal fibula. Ankle ROM was dorsiflexion of 10 degrees and 45 degrees plantar flexion. The examiner recommended a less demanding job with decreased hours on his feet. At the 26 June 2005 orthopedic clinic appointment, 2 months prior to separation, the examiner stated ROM was approximately 50% and there was 1 cm calf atrophy. No fracture line was seen on X-ray, but the bony architecture in the distal tibia and fibula appeared osteopenic (decreased density). There was minimal soft tissue swelling. The examiner recommended weight training exercises to increase ROM.

At the 19 August 2005 physical therapy clinic examination, less than one month prior to separation, the CI had a mild gait deviation with limited dorsiflexion (lacking 5 degrees) and plantar flexion was 42 degrees. Dorsiflexion increased to 0 degrees (neutral) after therapy. At the same-day VA Compensation and Pension (C&P) examination, less than one month before separation, the CI reported constant pain and decreased ROM. Physical examination showed a slightly abnormal gait with a slight left-sided limp. The CI did not require use of a cane but had an ankle brace. There was diffuse tenderness with slight swelling of the left ankle. Ankle ROM was dorsiflexion of 5 degrees and plantar flexion of 20 degrees, both with pain. There was no additional limitation of fatigue, weakness, lack of endurance, or incoordination after repetitive use.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left ankle bimalleolar fracture 10%, coded 5271 (ankle, limited motion). The VA rated the left fibular and ankle fracture condition 30%, analogously coded 5271-5262 (ankle, limited motion-tibia and fibula, impairment) based on the C&P examination, citing marked knee or ankle disability.

The panel considered the ROM examinations proximate to separation to be more than moderately limited and more nearly approximated a “marked” degree of limitation required for the maximum 20% rating under this code, and supported by the presence of an abnormal gait and slight swelling, and consideration of functional loss. 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 20% for the left ankle bimalleolar fracture, coded 5271.

BOARD FINDINGS: In the matter of the left ankle bimalleolar fracture, the panel recommends a disability rating of 20%, 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	
Left Ankle Bimalleolar Fracture	5271	20%	

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 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 30 Aug 19
(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 s 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 10% to 20% 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 office of the Deputy Commandant, Manpower and Reserve Affairs, for appropriate changes to your personnel records and notification to you upon completion.