RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-05424
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081022

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Signal Support Systems Specialist, medically separated for “limitation of motion, right ankle” with a disability rating of 20%.   

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’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 - 20080918	VARD - 20090330	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Limitation of Motion, Right Ankle	5099-5003-5271	20%	Degenerative Joint Disease of Right Medial Malleolus Status Post Right Ankle Fracture and Plantar Spur	5010-5271	10%	20081202	
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’s ankle condition began in April 2007 when he suffered an acute eversion injury while running with his full battle gear.  Radiographic studies found that he had a small acute incomplete fracture involving the medial malleolus.  After an orthopedic evaluation, he was continued on conservative therapy.  In February 2008, he underwent arthroscopic surgery of the talus in an effort to improve his overall status.  
During the 11 August 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the examiner noted a swollen right lateral malleolus area, with decreased right ankle range of motion (ROM).  The MEB NARSUM examination the same day noted CI complaints of right ankle aggravation upon walking at a brisk pace for more than 1/2-mile, and pain and stiffness by the end of the day.  Physical examination revealed slight swelling of the right lateral aspect but no effusion.  Gait and station was normal with no evidence of atrophy.  Right ankle ROM showed dorsiflexion of 12 degrees (normal 20) and plantar flexion of 28 degrees (normal 45), limited by pain, but not by fatigue, weakness, lack of endurance or incoordination.  

At the 2 December 2008 VA Compensation and Pension (C&P) examination, 1 month after separation, the CI reported right ankle pain, stiffness and instability.  Physical examination showed a coordinated, even gait, and transfer from chair to examination table without difficulty.  The right foot was warm to touch, with mild tenderness, but no joint laxity or instability.  Right ankle ROM showed dorsiflexion of 15 degrees and plantar flexion of 45 degrees.  There was no change in ROM due to repetition or fatigability, and no instability, incoordination or weakness.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ankle condition 20%, analogously coded 5099-5003-5271 (degenerative arthritis, limited motion of the ankle), citing marked limitation of motion.  The VA rated the right ankle condition 10%, analogously coded 5010-5271 (traumatic arthritis, limited motion of the ankle), based on the C&P examination, citing moderate limited motion of the ankle.  Members noted that the PEB assigned the maximum rating (20%) available under code 5271.  Because there was no ankylosis, nonunion or malunion, VASRD §4.71a offers no applicable joint code which would yield a rating higher than 20%.  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.  

AR20190005637, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX	

	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.