RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-04631 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20060531

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Electrician, medically separated for “left ankle pain” with a disability rating of 10%.

CI CONTENTION: The CI requested review of all conditions to include 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 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 - 20060224	VARD - 20060605	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Ankle Pain	5299-5003	10%	
Post-Operative Left Ankle Sclerosis Residuals and Bone Spurs	
5271	
10%	
20060315	
Tibiotalar Spurring…	Cat II					
Status Post Brostrom and Ankle Scope Procedures of the Lower Extremity	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	
	
ANALYSIS SUMMARY:

Left Ankle Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left ankle condition began in March 2004. On 22 October 2004, the CI underwent ligament repair surgery on the left ankle.       One year later (5 October 2005), the CI

underwent additional surgery to remove excess bone and synovium (soft tissue surrounding a joint) from the left ankle.  Despite rehabilitation, the CI’s left ankle pain continued.

At the 2 January 2006 MEB NARSUM examination, 4 months prior to separation, the CI reported chronic pain, tightness, and limitation of ankle dorsiflexion to both ankles. The physical examination (PE) revealed left ankle dorsiflexion to 10 degrees (normal 20). There was no fullness or weakness of the surrounding tendons about the left ankle. Distal sensation was intact and the left ankle joint appeared to be stable. At the 15 March 2006 VA Compensation and Pension (C&P) examination, 2 months prior to separation, the CI reported constant left ankle pain that traveled up the sides of the calf. Pain elicited by physical activity was described as sharp. The PE revealed a normal gait. Left ankle ROM was painful and decreased noting dorsiflexion to 10 degrees and plantar flexion to 20 degrees (normal 45). Tenderness and a slight effusion of the ankle joint was present. There was no evidence of local edema, joint weakness, abnormal or guarding movements, or subluxations.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left ankle condition 10%, analogously coded 5299-5003 (degenerative arthritis). The PEB also listed ”tibiotalar spurring, treated with arthroscopic excision of exostosis and synovitis” and “status post Brostrom and ankle scope procedures of the left lower extremity” as related Category II conditions (contributed to the primary unfitting condition but not separately ratable). In this case the Category II conditions are aspects of the same disability and are not separately unfitting conditions or separately ratable IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The VA also rated the post- operative left ankle sclerosis residuals and bone spurs 10%, coded 5271 (ankle limited motion), based on the C&P examination citing painful and limited ROM. The panel agreed that the ROM examinations proximate to separation, coupled with the finding of a “normal gait” would support no greater than the “moderate” limitation of motion required for the 10% rating under code 5271. Additionally, there was evidence of painful motion causing functional loss, also supporting the 10% rating (based on §§4.59, 4.40 and 4.45) as adjudicated by the PEB. Therefore, there was no advantage to the CI to change the VASRD code for rating purposes. 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 §4.71, 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:

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 20May20

From:

Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW  (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 9 Sep 19

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.