SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

MEMORANDUM FOR THE DIRECTOR, AIR FORCE REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on 
	Case Number PD-2018-00207

	In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual from the United States Air Force.  After carefully reviewing the application and medical separation case file, the PDBR recommended no re-characterization of the separation or modification of the disability rating previously assigned.  I recommend you accept this proposed decision.

The covered individual (CI) was an active duty  E4, Security Forces Journeyman, medically separated for “chronic right ankle pain status post (S/P) reconstruction” with a disability rating of 10%.  The PEB coded the condition 5003 (degenerative arthritis), citing general DoD and VASRD guidelines.  The VA also rated the condition 10%, coded 5271 (limitation of ankle motion), based on the Compensation and Pension examination and citing the applicable criterion for “moderate” limitation (and acknowledging painful motion).  Code 5271 confers its highest 20% rating for “marked” limitation of motion.  Panel members agreed that the range of motion limitation in evidence would not justify the higher rating under code 5271.  There was no ankylosis, nonunion, malunion, or other ratable criterion in evidence that would support a rating higher than 10% under any applicable ankle joint code available in VASRD §4.71a.  The panel additionally considered a higher rating for functional impairment under code 5299-5262 (analogous to ‘tibia and fibula, impairment’ for contiguous ankle disability), but agreed that it was not justified (normal gait and routine activities unaffected).  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.  

In the matter of the contended migraine headaches, supraventricular tachycardia, insomnia, and vertigo, these conditions were adjudicated as Category II (can be unfitting but are not currently compensable or ratable).  The narrative summary documented the headaches as “occasional flare-ups” responsive to medication; the tachycardia as non-recurrent after discontinuation of medication; the insomnia as “stable with occasional Ambien use;” and the vertigo as “no flare-ups in quite some time.”  None of the conditions were profiled or implicated in the commander’s statement, and none failed retention standards.  The panel’s main charge is to assess the fairness of the PEB’s Category II determination for each of these conditions.  There was no performance-based evidence from the record that any of them significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB adjudication of any of the listed conditions, so no additional disability rating is recommended.

SAF/MRB
3351 Celmers Lane
JBA NAF WashingtoN, MD 20762-6435

Dear XXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2018-00207.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no rating modification or re-characterization of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.