RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-05777 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20070415

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Logistics/Embarkation and Combat Service Support Specialist, medically separated for “loss of subtalar [right ankle] motion” with a disability rating of 10%.

CI CONTENTION: “I believe the rating I was given is too low for someone whom has lost partial use of their limb.” 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 - 20070226	VARD - 20070914	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Loss of Subtalar [Right Ankle] Motion	5271	10%	
Right Calcaneus Fracture, S/P ORIF	
5271	
20%	
20070804	
Right Calcaneus Fracture, Status Post (S/P) Open Reduction Internal Fixation (ORIF)	Cat II					
Achilles Contracture						
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Loss of Subtalar [Right Ankle] Motion. According to the service treatment record and MEB narrative summary (NARSUM), the CI sustained a right heel fracture after jumping off an 8-foot fence in March 2006. On 5 May 2006, the CI underwent surgical fixation of the fractured right heel. Post-operatively, despite aggressive physical therapy (PT), his heel pain and stiffness returned. A PT encounter dated 28 November 2006, 5 months before separation, documented right ankle tenderness and dorsiflexion to 5 degrees (normal 20) and plantar flexion to 5 degrees (normal 45). Two days later, the MEB NARSUM examination recorded that the CI developed a contracture of his right Achilles tendon and pain in the subtalar region. The CI was not able to run despite aggressive PT and rehabilitation. The physical examination (PE) revealed a well- healed scar over the right side of the ankle. Right ankle dorsiflexion was “neutral” (equivalent to

0 degrees) and plantar flexion was 20 degrees. There was no right ankle or Achilles tendon tenderness.

At the 4 August 2007 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported decreased right ankle range of motion (ROM) and right foot pain which limited his walking distance. The PE revealed an antalgic gait. The right ankle and Achilles tendon were tender and the provider noted positive right ankle instability described as the CI’s inability to ‘balance on one foot’. Right ankle dorsiflexion was 10 degrees and plantar flexion was 15 degrees with painful motion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right ankle condition 10%, coded 5271 (ankle, limited motion). The PEB’s Category II conditions “right calcaneus fracture, s/p ORIF” and “Achilles contracture,” which contributed to the primary unfitting condition, were properly subsumed under the overall rating for the loss of subtalar motion IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The VA rated the right ankle condition 20%, coded 5271 based on the C&P examination, citing “marked” limitation of motion.

Panel members first agreed that probative value was equally apportioned to the MEB NARSUM and VA examinations. Panel members then agreed that code 5271 was most appropriate for this case in the absence of joint ankylosis or ankle malunion. The panel concluded that the preponderance of STR ROM evidence corroborated by the MEB NARSUM examination most closely reflected a “marked” right ankle limitation of motion to support a 20% rating, despite right ankle ROM improvement documented during the VA examination. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the right ankle condition, coded 5271.

BOARD FINDINGS: In the matter of the right ankle condition, the panel recommends a disability rating of 20%, 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	
Loss of Subtalar [Right Ankle] Motion	5271	20%	

2	PD-2017-05777

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
12 Oct 20

From: To:

Subj:

Ref:

Director, Secretary of the Navy Council of Review Boards 
PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)
(a) DoDI 6040.44
(b)	PDBR ltr of 29 Jan 20
(b)	

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy for appropriate action.

2.	On 7 October 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) took action in your case by accepting the recommendation of the PDBR. Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEB) from 10% to 20% without re-characterization of your discharge.

3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, has been forwarded to the office of the Deputy Commandant, Manpower and Reserve Affairs, for appropriate changes to your personnel records and notification to you upon completion.