RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXX	CASE:  PD-2017-05254
BRANCH OF SERVICE:  army	SEPARATION DATE:  20090921

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Cavalry Scout, medically separated for “limitation of motion of right ankle” with a disability rating of 20%.  

CI CONTENTION:  No specific contention was made.  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 - 20090616	VARD - 20100115	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Limitation of Motion of Right Ankle	5271	20%	Right Ankle Osteoarthritis	5003	10%	20090507	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Ankle Limitation of Motion.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent a right talus non-union excision in October 2001, and later had an arthroscopic thermal capsule shrinkage after he developed instability.  He reinjured his right ankle in 2004 and underwent the first stage of a modified two-stage Brostrom in October 2005, which did not relieve his pain.  After the second stage in April 2006, he experienced limitation of ankle motion as well as chronic pain.  In January 2007, he had a surgical debridement of the distal tibia and medial talus with partial synovectomy.   

At the 7 May 2009 VA Compensation and Pension (C&P) examination, 5 months before separation, the CI reported right ankle pain, swelling and decreased range of motion (ROM) aggravated by exercise, running, walking, climbing, rucking and changes in weather.  Physical examination showed a normal gait and measured ROM revealed dorsiflexion of 20 degrees (normal) and plantar flexion of 45 degrees (normal). The examiner noted pain with standing and weight bearing, but not with ROM testing.  

The 29 May 2009 MEB NARSUM examination, 4 months prior to separation, noted CI complaints of right ankle pain and limitation of motion.  Physical examination showed chronic swelling, tenderness and decreased sensation.  The goniometric ROM evaluation showed dorsiflexion of 10 degrees and plantar flexion of 20 degrees, with pain partially limiting motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 20%, coded 5271 (limited motion of ankle), citing marked limitation of motion.  The VA rated the right ankle condition (and right knee) 10%, coded 5003 (degenerative arthritis), based on the C&P examination citing X-ray evidence of arthritis in two or more major joints without limited or painful motion.  Members first considered the disparate examinations in evidence proximate to separation, and agreed that the NARSUM held more probative value because it was closer to separation and more consistent with the service record.  Ankle ankylosis was not present in any of the examinations, and there was no evidence of marked knee disability to support a 30% rating under codes 5255 or 5262 code (femur impairment or tibia/fibula impairment).  There was no limitation of flexion or extension (5260, 5261), and no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258) to support a rating under these respective codes.  The panel noted that the PEB assigned the maximum rating available under code 5271.  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 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:

AR20190005129, XXXXXXXXXX

Dear XXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.