RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXX	CASE: PD-2017-04618
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20050224

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Network Switching Systems Operator Maintainer, medically separated for “chronic right ankle pain” with a disability rating of 0%.

CI CONTENTION:  “Review all conditions.”  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 - 20041028	VARD - 20050917	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Ankle Pain	5099-5003	0%	Right Ankle Strain	5271	0%	20050912	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Chronic Right Ankle Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI sprained his right ankle and subsequently underwent a Brostrom procedure in August 2000. A diagnostic arthroscopy in August 2001, for continued right ankle pain, revealed no further abnormalities.

At the 24 September 2004 MEB NARSUM examination, 5 months prior to separation, the CI had continued right ankle pain and could no longer function in his military specialty. Physical examination showed anterior tenderness, but no deformity, effusion or warmth. Right ankle ROM was full with no instability during anterior drawer and talar tilt tests. An X-ray was normal with no evidence of acute or chronic bone pathology. During the 5 October 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months before separation, the CI complained of bilateral ankle pain and instability which prevented carrying a ruck sack over 30 pounds for a great distance. Physical examination revealed bilateral ankle pain with mild decreased range of motion (ROM); no measurements were provided. A MEB NARSUM addendum with formal ROM measurements was dictated on 18 October 2004, and documented active dorsiflexion of both ankles to 5 degrees (normal 20) and plantar flexion to 55 degrees

(normal 45) on the right and 45 degrees on the left. There was no significant pain on ROM testing and the measurements represented the mechanical limits of the ankle joints.

The CI was seen in the emergency department on 28 November 2004 for an acute right ankle sprain, and the provider noted right lateral malleolar tenderness with decreased right ankle ROM. Ankle X-rays were negative and the CI was placed on crutches and quarters.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right ankle condition 0%, analogously coded 5009-5003 (degenerative arthritis), noting symmetric passive ROMs and citing the US Army Physical Disability Agency pain policy. The VA also rated the right ankle condition 0%, but coded 5271 (ankle, limited motion), based on the C&P examination, citing a noncompensable evaluation unless there is moderate limited ankle motion. Panel members noted that the right ankle ROM measurements were essentially symmetric to the left, but the CI had complaints of sprain injury to both ankles and therefore comparison of the right to the left ankle was not to an unaffected (normal) joint. The NARSUM ROMs were closest to separation and documented dorsiflexion to 5 degrees, which the panel agreed was consistent with a “moderate” limitation of motion warranting a 10% rating under code 5271. The panel considered alternative VASRD ankle and analogous codes, but all were not advantageous to 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 Right Ankle Pain	5271	10%	

The following documentary evidence was considered:

2	PD-2017-04618

DEPARTMENT OF THE ARMY
ARMY REVIEW BOARDS AGENCY 251 18TH STREET SOUTH, SUITE 385
ARLINGTON, VA 22202-3531

AR20190013938, 

Dear XXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability. I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation. This will not result in any change to your separation document or the amount of severance pay. A copy of this decision will be filed with your Physical Evaluation Board records. I regret that the facts of the case did not provide you with the outcome you may have desired.

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.

A copy of this decision has also been provided to the Department of Veterans Affairs.