RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXX CASE: PD1201483 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130404 

SEPARATION DATE: 20021218 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (92A/Auto Logistics Specialist) medically 
separated for a Grade III right ankle sprain. The CI injured her right ankle when she jumped out 
of a military truck and landed in a pothole. Her first surgery was performed in August 2000 for 
a Grade III ankle sprain. There were no bony abnormalities. Despite surgeries, physical 
therapy/rehabilitation, profiles and medications, the right ankle condition could not be 
adequately rehabilitated 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 ankle condition, characterized as 
“right ankle post Grade III ankle sprain with two procedures to repair anterior talofibular 
ligament” 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 ankle pain 
post Grade III sprain with two procedures” as unfitting, rated 0%. The CI appealed to the Formal 
PEB (FPEB) which increased the rating to 20% referencing the US Army Physical Disability 
Agency (USAPDA) pain policy. 

 

 

CI CONTENTION: “My last surgery on my ankle was in 2004 with no resolve in any of the 
problems. In total, I’ve had 4 surgeries. I'm in constant pain. I recently went to a German 
Orthopedic Clinic in Oct 2011, with hopes that I could be helped. After physical therapy, 
injections and a walking cast for 6 weeks, the issues and pain has not subsided. I was informed 
by the doctor that there is nothing more that can be done due to all of the surgeries and 
Arthrosis in my ankle. My last visit with them was April 2012. My physical activities are still 
limited to walking, which is also painful. Any aggressive movements/activities make the pain 
worse. My ankle and part of my calf are constantly swollen. Quality of life is filled with pain 
and limitations. I hope you will consider my new evidence and increase my disability benefits.” 

 

 

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 ankle 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 
respective Service Board for Correction of Military Records. The Board acknowledges the CI’s 
information regarding the significant impairment with which her service-connected condition 
continues to burden her; but, must emphasize that the Disability Evaluation System (DES) has 
neither the role nor the authority to compensate members for anticipated future severity or 
potential complications of conditions resulting in medical separation. That role and authority is 
granted by Congress to the Department of Veteran Affairs (DVA), operating under a different 
set of laws. 

 

 

 


RATING COMPARISON: 

 

Service FPEB – Dated 20020910 

VA - (3 Mos. Pre-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Right Ankle 

5099-5003 

20% 

Neuroma R Ankle 

5299-5271 

20% 

20020924 

No Additional MEB/PEB Entries 

Other x 1 

20020924 

Rating: 20% 

Rating: 20% 



Derived from VA Rating Decision (VARD) dated 20021219 (most proximate to date of separation [DOS]). 

 

 

ANALYSIS SUMMARY: 

 

Right Ankle Condition. The narrative summary (NARSUM) notes that the right ankle condition 
was the result of the CI’s having jumped out of the back of a truck and into a hole twisting her 
right ankle severely. She experienced a large amount of swelling and pain immediately 
afterward. She was diagnosed with Grade III ankle sprain and surgery was performed in June 
2000. Subsequent treatment with rehabilitation, PT, profiles and medication were tried but she 
continued to complain of right ankle pain and instability. It was concluded that the first 
attempt to repair her lateral ligaments had not been successful and she underwent a second 
surgery to tighten her anterior talofibular ligaments in July 2001. This surgery also failed to 
improve the pain and instability. 

 

At the MEB exam, 8.5 months prior to separation, the CI reported that she experienced pain 
with any type of activity with occasional rolling of her ankle. She felt unable to do her job or to 
climb in or out of vehicles as her job as an Automated Logistics Specialist required. The MEB 
physical exam noted a well healed non-tender scar with normal strength and sensation. Gait 
was normal and right ankle plantar flexion was 35 degrees (normal 45 degrees/opposite side 15 
degrees) and dorsiflexion was 25 degrees (normal 20 degrees/opposite side 25 degrees), with 
inversion of 10 degrees (opposite side 25 degrees) and eversion of 12 degrees (opposite side 25 
degrees). Magnetic resonance imaging (MRI) dated 5 February 2002 revealed a partial 
disruption of the peroneus brevis tendon and a probable tear of the deltoid ligaments. A 
neuroma was diagnosed on the basis of a bone scan done in October 2002. The DD Form 2808 
exam indicated “pain to palpation and limited ROM right ankle.” 

 

At the VA Compensation and Pension (C&P) exam performed 3 months prior to separation, the 
CI reported that she continued to experience pain in the right ankle although she was able to 
get some relief with elevation of her foot. “Occasionally, she has a cold feeling and numbness 
and tingling sensation in a sock like pattern of the right ankle on the lateral side.” She had been 
on a profile since the accident and had been elevating her foot when she was doing her 
sedentary work. The CI related she had recently been told she may have reflex sympathetic 
dystrophy of her right ankle. She had been taking Tramadol every 6 hours but felt it did not 
help the pain. She had limited her activities considerably in order to keep the pain threshold 
tolerable. The physical exam showed tenderness and 2+ pitting edema over the right lateral 
malleolus. Motor, reflexes, and vascular exams were normal. Dorsiflexion was 0 degrees 
(normal 20 degrees) and plantar flexion was 50 degrees (normal 45 degrees). The examiner 
recorded a normal non-antalgic gait in tennis shoes. Diagnosis included chronic right ankle pain 
and reflex sympathetic dystrophy right ankle. VA records document post-separation right ankle 
surgery. 

 

The Board directs attention to its rating recommendation based on the above evidence. 
Although choosing different approaches to coding, both the FPEB and the VA arrived at similar 
ratings. The FPEB characterized the right ankle condition as post Grade III ankle sprain coded 
analogously as 5099-5003 (degenerative arthritis) and with application of the USAPDA Pain 
Policy awarded a 20% rating based on the presence of constant and marked pain. The VA, 


noting that a neuroma had been identified on a bone scan performed in October 2002, 2 
months prior to separation, described the disability as neuroma, right ankle, and residual of 
surgery and coded it analogously as 5299-5271 (limitation of motion of the ankle). Further 
noting that dorsiflexion was severely limited while other motion was mildly limited, it 
considered there to be marked limitation of motion of the ankle justifying a rating of 20%. They 
noted that rating under nerve paralysis (8525) would have resulted in the same percentage 
even if it could be conceded that the paralysis was “severe.” 

 

Members also discussed a 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 the normal gait cited by both the MEB and the VA 
examiners, and reasonably intact functionality of the joint, all members agreed that the 
‘marked’ 30% rating was not supported under 5262. Although numerous “ideal” analogous 
coding options at 20% were considered, none were predominate to the PEB analogous coding 
at 20%. 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 ankle pain 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. As discussed above, PEB 
reliance on the USAPDA pain policy for rating right ankle condition was operant in this case and 
the condition was adjudicated independently of that policy by the Board. In the matter of the 
right ankle pain condition 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 Ankle Condition 

5099-5003 

20% 

RATING 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120627, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxx, AR20130009581 (PD201201483) 

 

 

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 xxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)