RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04515
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20090928

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Ground Radio Communications Craftsman, medically separated for “limited motion of the right ankle” with a disability rating of 10%.  

CI CONTENTION:  The condition continues to worsen.  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 - 20090527	VARD - 20110817	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Limited Motion of the Right Ankle	5271	10%	Right Ankle Pain Syndrome	5299-5271	10%	20110606	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Limited Motion of the Right Ankle.  According to the service treatment record and MEB narrative summary (NARSUM), the CI sprained (an inversion injury) his right ankle in December 2006 while playing basketball.  Magnetic resonance imaging (MRI) done on 16 March 2007, showed a complete tear of the anterior talo-fibular and calcaneo-fibular ligaments.  He underwent surgical repair in March 2008.  Following surgery, the CI did well.  He unfortunately returned to weight bearing sooner than advised by the orthopedic surgeon.  At follow-up on 20 May 2008, he was noted to have a stable ankle with full range of motion (ROM) and minimal pain.  He was walking without difficulty.  On 17 September 2008 in orthopedics, the CI reported that he continued to have pain and could not return to his normal unrestricted activities.  On examination, the ankle was stable and the scars well healed.  Tenderness and mild swelling were present.  Dorsiflexion (toes up) was limited to 10 degrees (normal 20) and plantar flexion (toes down) was limited to 20 degrees (normal 45).  X-rays showed some degenerative changes.  Sensory changes consistent with a neuroma (abnormal growth) of the superficial peroneal nerve were present, but no impact on duty was recorded.  While the CI was able to meet all duty requirements, he was not thought to be able to perform all duties in a deployed environment and MEB was initiated.  

The 23 January 2009 MEB NARSUM, 8 months prior to separation, noted the CI had improved after surgery until he began running.  He reported constant pain and subjective instability.  On examination, the scar was well healed and strength normal.  The objective findings mirrored those from the September 2008 orthopedic evaluation.  The 6 June 2011 VA Compensation and Pension (C&P) examination was 21 months after separation and held little probative value for disability rating at the time of separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 10%, coded 5271 (limited motion of the ankle).  The VA also rated the right ankle condition 10%, coded analogously to 5271 citing moderate limited motion.  The VA rater noted that VA records showed that the CI reported in August 2010 that he had been out of medications since February 2010.  In September 2010 (12 months after separation), he reported that he liked to hunt, fish, golf, and coach football.  He denied difficulty with walking.  The panel considered if the limitation of motion was “moderate” or “marked” when considered under 5271.  All panel members agreed the limitation of motion was no more than “moderate,” therefore supporting the 10% rating adjudicated by the PEB.  This is supported by the activity level after separation which the CI reported at VA evaluations.  A higher rating of 20% was not indicated in the absence of “marked” limited ROM of the ankle.  After due deliberation, considering all of 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.  

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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170519, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-04515.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						Sincerely,

	

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings