RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX CASE: PD1200525 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130418 

SEPARATION DATE: 20020227 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty PVT/E-1 (92G/Food Service Specialist) medically 
separated for right Achilles tendon avulsion. The CI sustained her right Achilles tendon avulsion 
condition during her 8th week of basic training in October 2001. After operative repair and a 
period of convalescent leave, the CI’s right Achilles tendon avulsion condition could not be 
adequately rehabilitated for her to meet the physical requirements of her Military Occupational 
Specialty (MOS) or satisfy physical fitness standards. She was issued a permanent L3 profile 
and referred for a Medical Evaluation Board (MEB). The right Achilles tendon avulsion 
condition, characterized as “right Achilles tendon avulsion status post repair” was forwarded to 
the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the 
MEB. The Informal PEB (IPEB) adjudicated right Achilles tendon avulsion as unfitting rated 20% 
with likely application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD). The CI 
made no appeals, and was medically separated with a 20% disability rating. 

 

 

CI CONTENTION: “I was given an automatic 20% for an Achilles tendon rupture. It was not an 
Achilles tendon rupture, a piece of my heel bone was broken off, still attached to the tendon, 
and shot up through my calf muscle like a torpedo. I was made to wait two day before they 
sent me to the doctor, and then was scheduled for emergency surgery. This left me with 3cm 
of atrophy in my calf muscle. (cont. in item 12) They had to place pins in the bone to hold my 
foot together. Currently, I live with pain, irreversible nerve damage and osteoarthritis. This 
request for review is due to incorrect information from the beginning. This was not an Achilles 
tendon rupture, it was much more and caused much more damage than that.” 

 

 

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, 
paragraph 5.e.(2). It is limited to those conditions determined by the PEB to be unfitting for 
continued military service and those conditions identified but not determined to be unfitting by 
the PEB when specifically requested by the CI. The rating for the unfitting right Achilles tendon 
avulsion condition is addressed below; and, no additional conditions are within the DoDI 
6040.44 defined purview of the Board. Any conditions or contention not requested in this 
application, or otherwise outside the Board’s defined scope of review, remain eligible for future 
consideration by the Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20011217 

VA - (~9 Mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Right Achilles Tendon 
Avulsion 

5271 

20% 

Right Achilles Tendon Rupture 
Status Post Repair 

5271 

20% 

20021122 

No Additional MEB/PEB Entries 

Other x 0 

 20021122 

Combined: 20% 

Combined: 20% 



Derived from VA Rating Decision (VARD) dated 20020305 (most proximate to date of separation [DOS]). 

 

 


ANALYSIS SUMMARY: 

 

Right Achilles Tendon Avulsion Condition. The narrative summary (NARSUM) notes that 
following X-ray confirmation of an avulsion fracture of the right Achilles tendon, the CI 
underwent surgical repair for the condition. On follow-up exam following convalescent leave, 
she reported pain only with weight bearing and not while sitting comfortably. Pain was judged 
to be minimal and intermittent. The MEB physical exam noted a well-healed posterior ankle 
scar. Range-of-motion (ROM) was 0 degrees of dorsiflexion and 45 degrees of plantar flexion. 
There was a palpable screw head that was mildly tender. Sensation was intact. Pulses were 2+ 
and plantar strength was 5/5 with a palpably intact Achilles tendon. X-ray study performed at 
the time showed an orthopedic screw in good position with healing of the bony fragment to the 
calcaneus. The examiner opined that the CI should have “a near full recovery of her ankle 
function after approximately 6 to 9 months.” 

 

The VA originally based its rating on the MEB’s findings in the absence of further data. 
However, a VA Compensation and Pension (C&P) exam was performed about 9 months post-
separation, at the CI’s request. Report of that exam stated that it was done because the CI had 
disagreed with the previous evaluation contending that there was hardware that had avulsed in 
the calf. She also mentioned calf atrophy, constant pain and swelling. Physical exam at that 
time revealed marked tenderness over the distal aspect of the tendon and the posterior 
calcaneus. ROM was recorded as dorsiflexion to neutral and plantar flexion to 40 degrees. 
Some discomfort on extremes of dorsiflexion was noted. Squeezing of the calf produced 
plantar flexion. Calf measurements were 33 cm on the right and 35 cm on the left. Another X-
ray study performed in November 2002 described the orthopedic screw embedded in the 
calcaneus with well corticated bony density abutting the superior calcaneus at the expected 
site of the Achilles tendon insertion. The examiner concluded that there was no evidence of 
hardware having avulsed into the calf. While acknowledging the CI’s complaints of numbness 
and tingling of the entire right leg and her mention of episodes of pain in the left foot, he 
thought it unlikely that any of these symptoms were associated with the surgical repair of the 
right Achilles tendon. Subsequent C&P (neurology) exam performed in May 2003, about 15 
months post separation, while confirming the 2 cm smaller circumference of the right calf 
muscle felt that the atrophy was most likely secondary to disuse after wearing immobilization 
device for an extended period of time. There was some weakness noted in the right foot but it 
was felt to be unlikely that it was due to a proximal radiculopathy. Electromyogram (EMG) 
study showed no abnormality according to a later C&P exam performed in December 2004. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB characterized the condition as right Achilles tendon avulsion with surgical repair and coded 
it as 5271 (ankle, limited motion of). Citing the ROM measured during the MEB exam and the 
stated expectation of full recovery for civilian life, they rated the disability at 20% for marked 
limitation of motion. The VA initially rated the condition in the same manner as the PEB, basing 
its decision on the MEB which was the only evidence available at the time. It subsequently 
amended its description of the condition to “right Achilles tendon rupture, status post repair 
with hardware and with calf atrophy” but maintained the rating at 20% for marked limitation of 
motion. The Board considered these exams and adjudications and concurred with the 
characterization of the limitation of movement as “marked”, thus justifying the 20% maximum 
allowable rating under 5271. The Board considered the timing of the surgery and MEB exam 
within 2 months of surgery and considered the VA exam 13 months post operatively (9 months 
post-separation) as having the highest probative value for permanent separation rating. 
Members also discussed a possible rating under 5262 (tibia and fibula, impairment of). A rating 
higher than 20% under this code (for ‘moderate’ ankle disability) would require a 
characterization of the ankle disability as “marked.” With relatively normal gait described in 
the VA exam most proximal to separation, and reasonably intact plantar flexion, all members 


agreed that the ‘marked’ 30% rating was not supported under 5262. The Board could find no 
route to a higher rating and thus after due deliberation, considering all of the evidence and 
mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient 
cause to recommend a change in the PEB adjudication for the right Achilles tendon avulsion 
condition. The Board concluded therefore that this condition could not be recommended for 
additional disability rating. 

 

 

BOARD FINDINGS: IAW DoDI 6040.44, provisions of DoD or Military Department regulations or 
guidelines relied upon by the PEB will not be considered by the Board to the extent they were 
inconsistent with the VASRD in effect at the time of the adjudication. The Board did not 
surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD 
were exercised. In the matter of the right Achilles tendon avulsion with surgical repair and IAW 
VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication. There 
were no other conditions within the Board’s scope of review for consideration. 

 

 

RECOMMENDATION: The Board, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Right Achilles Tendon Avulsion with Surgical Repair 

5271 

20% 

COMBINED 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120603, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxx, AR20130009620 (PD201200525) 

 

 

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD 
PDBR) recommendation and record of proceedings pertaining to the subject individual. Under 
the authority of Title 10, United States Code, section 1554a, I accept the Board’s 
recommendation and hereby deny the individual’s application. 

This decision is final. The individual concerned, counsel (if any), and any Members of Congress 
who have shown interest in this application have been notified of this decision by mail. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)