RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201277 SEPARATION DATE: 20030922 

BOARD DATE: 20130314 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (92Y20/Unit Supply Specialist), medically 
separated right peroneal tendonitis with mild subluxation and snapping of the tendon over the 
lateral malleolus and hence forward will referred to as a right ankle condition. In June 2002 the 
CI noted atraumatic right ankle pain while running. She described the pain as extremely sharp, 
occurring daily, which increased with the wearing of her boots. She was treated extensively 
and conservatively with multiple modalities to include local steriod injections, casting, and 
custom orthotics yet none of them helped her. She was even offered surgery to correct the 
subluxing peroneal tendon yet declined, as the rehabilitation time was too long. The CI did not 
improve adequately with treatment 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 MEB forwarded right 
peroneal tendonitis with mild subluxation, not responding to conservative treatment and not 
amenable to surgical correction. No other conditions were forwarded to the Physical 
Evaluation Board (PEB). The PEB adjudicated the right ankle condition as unfitting, rated 0% 
with application of the US Army Physical Disability Agency (USAPDA) pain policy. The CI made 
no appeals, and was medically separated with a 0% disability rating. 

 

 

CI CONTENTION: “Since discharge from the Military in 2003, my service connected injury to my 
right ankle has affected me either through having to take or change medication that only 
temporarily release the pain or just do not work at all. It also affects the physical activity That I 
am able to take part in, theis[SP] affecty [SP] Since manners in which I interact with my 
daughter, as I am in pain later.” (sic) 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44, Enclosure 3, paragraph 5.e. (2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings 
for unfitting conditions will be reviewed in all cases. The asthma condition rated by the VA at 
separation and listed on the DA Form 294 is not within the Board’s purview. 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 Army Board for Correction of Military 
Records. 

 

 

 

 

 

 

 

 

 

 


RATING COMPARISON: 

 

Service IPEB – Dated 20030610 

VA (~1 Mos. Post-Separation) – All Effective Date 20030923 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Right Peroneal Tendonitis 
with Mild Subluxation and 
Snapping of the Tendon 

Over the Lateral Malleolus 

5099 5024- 

5003 

0% 

Right Ankle Peroneal Tendonitis 

5014-5271 

10%* 

20030804 

.No Additional MEB/PEB Entries. 

Asthma 

6602 

10% 

20030804 

Combined: 0% 

Combined: 20% 



*Increased to 20% and recoded from 20100128 with an increased combined rating to 30% effective 20100128. 

 

 

ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed in the CI’s application 
regarding the significant impairment with which her service-incurred condition continues to 
burden her. The Board wishes to clarify that it is subject to the same laws for service disability 
entitlements as those under which the Disability Evaluation System (DES) operates. The 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 Veterans Affairs (DVA), operating under 
a different set of laws (Title 38, United States Code). The Board evaluates DVA evidence 
proximal to separation in arriving at its recommendations, but its authority resides in evaluating 
the fairness of DES fitness decisions and rating determinations for disability at the time of 
separation. 

 

Right Ankle Condition. In the summer of 2000 the CI began having atraumatic right lateral 
ankle pain and was diagnosed with peroneal tendonitis. She reasonably declined surgical 
treatment to correct a subluxing peroneal tendon due to a potential long rehabilitation. 
Conservative treatment attempts were made with custom foot orthotics with lateral and 
medial wedges, short leg cast for a month, steroid injections none of which provided significant 
relief. The permanent profile limitations included; no prolong standing > 30 minutes, no 
marching, and no wearing the LBE, Kevlar, or protective mask. The profile allowed for lifting up 
to 10 pounds, sit-ups for the physical training testing and walk, bicycle, swim at own pace and 
distance. The commander’s statement corroborated her medical condition and the significant 
functional limitations impairing her ability to perform in her MOS. There were two goniometric 
range-of-motion (ROM) evaluations in evidence, with documentation of additional ratable 
criteria, which the Board weighed in arriving at its rating recommendation; as summarized in 
the chart below. 

 

Ankle ROM 

MEB ~6 Mos. Pre-Sep 

PT ~4 Mos. Pre-Sep 

VA C&P ~1 Mo. Pre-Sep 

Right 

Right 

Right 

Dorsiflexion (0-20°) 

10° 

14° 

 

Plantar Flexion (0-45°) 

40° 

35° 

 

Comment 

 

 

Decreased ROM, painful motion 

§4.71a Rating 

10% 

10% 

10% 



 

At the MEB exam, the CI reported chronic right ankle pain. She was not taking pain medications 
at the time of the exam. The MEB physical exam demonstrated tenderness to palpation at the 
right peroneal tendon, a mild clicking sound with ROM, decreased skin pigmentation at the 
injection site, otherwise normal dermatologic, neurovascular and muscular findings, normal 
arch height, mild pronation bilaterally on stance and pain in the entire ankle with a one-legged 
stance and tiptoeing. At the VA Compensation and Pension (C&P) exam after separation, the CI 
additionally reported constant ankle pain, 7-8 of 10 at its baseline but could reach 10 of 10 in 
intensity, could carry up to 30 pounds and she was not taking pain medications at the time of 


the exam. The C&P exam demonstrated a normal gait and posture, normal neuromuscular 
findings of the lower extremities, and normal right ankle X-rays. 

 

The Board directs attention to its rating recommendation based on the above evidence. This 
rating includes consideration of functional loss lAW VASRD §4.10 (functional impairment), §4.40 
(functional loss), §4.45 (DeLuca), and §4.59 (painful motion). The Board notes that the VA used 
the MEB’s goniometric readings which is compliant with VASRD §4.46 (accurate measurement) 
which were also similar to the PT ROM exam. The PEB and VA chose different coding options 
for the condition, but this did not bear on rating and both assigned a rating IAW VASRD 
§4.71a—Schedule of ratings–musculoskeletal system. The PEB’s DA Form 199 reflected 
application of the USAPDA pain policy for rating, and its 0% determination was inconsistent 
with §4.71a standards for the 5003 code (arthritis, degenerative). The VA assigned a 10% rating 
for decreased painful motion which is consistent for the 5271 code (limitation of, ankle). The 
Board agreed there is no evidence of incapacitating episodes to support additional or a 20% 
rating under the 5003 code. The Board considered higher ratings under the VA’s chosen code 
or under the 5020 code (synovitis) and 5024 code both of which default to the 5003 criteria, 
and agreed the evidence is insufficient to justify a higher rating under these codes. There is no 
evidence of ratable peripheral nerve impairment which would provide for additional or higher 
rating. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 
(reasonable doubt), the Board recommends a disability rating of 10% for the right ankle 
condition. 

 

 

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. As discussed above, PEB reliance on the USAPDA pain policy for rating right 
ankle was operant in this case and the condition was adjudicated independently of that policy 
by the Board. In the matter of the right ankle condition, the Board unanimously recommends a 
disability rating of 10%, coded 5099 5024-5003 IAW VASRD §4.71a. There were no other 
conditions within the Board’s scope of review for consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of her prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Right Peroneal Tendonitis with Mild Subluxation and Snapping 
of the Tendon Over the Lateral Malleolus 

5099 5024-5003 

10% 

COMBINED 

10% 



 

 

 

 

 

 

 

 

 

 

 

 


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 

 

 

 

 

 xxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxx, AR20130006864 (PD201201277) 

 

 

1. 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 to modify the individual’s disability rating to 10% without recharacterization 
of the individual’s separation. This decision is final. 

 

2. I direct that all the Department of the Army records of the individual concerned be corrected 
accordingly no later than 120 days from the date of this memorandum. 

 

3. I request that a copy of the corrections and any related correspondence be provided to the 
individual concerned, counsel (if any), any Members of Congress who have shown interest, and 
to the Army Review Boards Agency with a copy of this memorandum without enclosures. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)