RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:    
BRANCH OF SERVICE:  MARINE CORPS 
CASE NUMBER:  PD1200214                                                                   SEPARATION DATE:  20050430 
BOARD DATE:  20121114 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an activated Reserve CPL/E-4 (3112, Traffic Management Specialist), 
medically  separated  for  posttraumatic  osteochondritis  desiccans,  right  talar  dome,  and 
posttraumatic right ankle arthrosis.  The CI sustained a severe right ankle inversion injury when 
he was under fire in Iraq, ran for protection and jumped into a three foot deep hole.  Despite 
three cortisone injections; non steroidal anti inflammatory drugs (NSAIDS); rehabilitation  and 
orthopedic  consults;  a  diagnostic  arthroscopy  abrasion  chondroplasty  and  a  right  ankle 
reconstruction  surgery  by  arthroscopy;  aggressive  physical  therapy  (PT)  and  use  of  an  ankle 
brace  and  cane, the  CI  failed to meet  the physical  requirements  of  his Military  Occupational 
Specialty (MOS) or satisfy physical fitness standards.  He was issued placed on light duty and 
referred  for  a  Medical  Evaluation  Board  (MEB).    The  PEB  adjudicated  the  posttraumatic 
osteochondritis desiccans, right talar dome, condition as unfitting, rated 20%, with application 
of  the  Department  of  Defense  Instruction  (DoDI)  1332.39  and  Veteran’s  Affairs  Schedule  for 
Rating Disabilities (VASRD).  The PEB also adjudicated the posttraumatic right ankle arthrosis 
condition  as  related  Category  II  diagnosis  (“contributing  to  the  unfitting  condition”).    The  CI 
made no appeals, and was medically separated with a 20% disability rating. 
 
 
CI  CONTENTION:    “THEY  RATED  ME  FOR  THE  RIGHT  ANKLE  TRAUMA  AFTER  THE  MEDICAL 
BOARD  WAS  DONE  I  HAD  ANOTHER  ANKLE  SURGERY  WITHOUT  IT  BEEN  TAKEN  IN 
CONSIDERATION  AT  THE  PEB.    ALSO  I  WAS  BEING  THREATED  FOR  PTSD,  BACK  PAIN  AND 
SHOULDER PAIN.  THE OTHER CONDITION WHERE CONNECTED BY VETERANS ADMINISTRATION 
BUT I HAD SINCE BEING MEDICALLY DISCHARGE I HAD TO SPEND AROUNG $ 500 A MONTH FOR 
MEDICAL  INSURANCE  FOR  ME  AND  MY  FAMILY.    THE  MAJORITY  WAS  FOR  ME.    I  HAD  THE 
FOLLOWING CONDITIONS CONNECTED TO THE SERVICE SINCE MAY 1, 2005 ONE DAY AFTER MY 
END  OF  ACTIVE  SERVICE:  1.  DYSTHTMIC  DISORDER  2.  RIGHT  ANKLE  Arthritis  3.  LOW  BACK 
PROBLEMS 4. KNEE PROBLEMS (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 unfitting right ankle trauma condition 
meets the criteria prescribed in DoDI 6040.44 for Board purview, and is accordingly addressed 
below.  The other requested conditions are 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 Board for Correction of Naval Records. 
 
 
 

 

RATING COMPARISON:  
 

Condition 

Posttraumatic 
Osteochondritis 
Desiccans, Right Talar 
Dome 
Posttraumatic Right Ankle 
Arthrosis 

Service PEB – Dated 20050224 

VA (~3 Mos. Post-Separation) – All Effective Date 20050501 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

5099-5003 

20% 

Category 2 

S/P Right Ankle Sprain w/ Residual 
FX & Ligament Rupture; 
Posttraumatic Osteochondritis, 
Posttraumatic Arthrosis 

5271 

20% 

20050808 

No Additional MEB/PEB Entries 

Combined:  20% 

Dysthymic Disorder . . . . .  
Discogenic Disease, Spondylosis, & 
Posterior Disc Protrusion T11-T12 
Left Knee PFS 

9433 
5243 
5260 

0% X 2 / Not Service-Connected x 4* 

Combined:  60%* 

30% 
10%* 
10%* 

20050829 
20061207* 
20061207* 
20050808 

* VARD 20050908 (Original) granted combined rating of 40%.  CI appealed two non-service connected conditions (LBP & Lt Knee 
PFS).  After  new C&P exam on  20061207, VARD 20070319 awarded full grant of appeal, adding both conditions and raising 
combined rating to 60%, all retroactive to DOS. 
 
 
ANALYSIS SUMMARY:  The Board acknowledges that the MEB was not available in the evidence 
before  it;  and,  could  not  be  located  after  the  appropriate  inquiries.    Further  attempts  at 
obtaining the relevant documentation would likely be futile.  The missing evidence potentially 
relates only to the scope of the Board discussed above; and, it is not suspected that the missing 
evidence would significantly alter the Board’s recommendations.  The Board also acknowledges 
the CI’s assertions that the PEB did not take his second right ankle surgery into consideration 
when adjudicating his case.  It is noted for the record that the Board has neither the jurisdiction 
nor  authority  to  scrutinize  or  render  opinions  in  reference  to  the  CI’s  statements  in  the 
application regarding suspected service-improprieties in the processing of his case.  The Board’s 
role is confined to the review of medical records and all evidence at hand to assess the fairness 
of PEB rating determinations, compared to VASRD standards, based on severity at the time of 
separation.    It  must  also  judge  the fairness  of PEB  fitness  adjudications  based on the  fitness 
consequences of conditions as they existed at the time of separation.   
 
Right  Ankle  Condition  (Posttraumatic  Osteochondritis  Desiccans,  Right  Talar  Dome;  and 
Posttraumatic Right Ankle Arthrosis).  Both of the PEB right ankle conditions were considered in 
rating  the  right  ankle  condition.    There  were  three  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.   
 

Right Ankle ROM 

MEB ~4.5 Mo. Pre-Sep 

Rehab consult ~2 Mo. Post-Sep 

VA C&P ~3 Mo. Post-Sep 

Dorsiflexion (0-20⁰) 
Plantar Flexion (0-45⁰) 

Comment:  Surgery 
20050418; 2 mo. after 
the PEB and .5 mo. prior 

to separation 

§4.71a Rating 

5⁰ 
“full” 

Lace up brace; antalgic gait; 
effusion; global tenderness 
to palpation(TTP); pain with 
resisted ankle motions; well 

healed incisions; 

sensation/motor intact 

20% 

17⁰ 
25⁰ 

Diffuse tenderness; “Right leg 
appears thinner - Right 34cm 
Left 39.5cm; “uses cane/brace 

at times” 

20% 

10⁰ 
15⁰ 

Limping gait; tenderness ankle; 

ankle brace; TTP; unable to 

repetitively stand on heels/toes 

due to pain; manual muscle 
testing dorsiflexors/plantar 

flexor 3/5 

20% 

 
The right ankle pain condition was well documented in the service treatment record (STR).  The 
CI fractured the right ankle in March 2003 which was confirmed by an X-ray in May 2003 that 
demonstrated a fracture of the lateral malleolus.  The CI continued with right ankle inversion, 
pain and laxity.  Magnetic resonance imaging (MRI) in December 2003 indicated a tear in the 
calcaneofibular  ligament  and  a  small  avulsion  fracture  in  the  posterior  aspect  of  the  distal 

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fibula.  The CI underwent a diagnostic arthroscopy and abrasion chondroplasty in March 2004.  
There  was  minimal  improvement  in  the  right  ankle  and  an  MRI  indicated  an  occult  fracture 
involving  the  posterolateral  aspect  of  the  talus. 
  The  MEB  examination  performed 
approximately 4 months prior to separation, noted continued pain when walking; an inability to 
run or jump; intermittent swelling; pain worse with cold and activity; and mild pain relief with 
NSAIDS.  The MEB physical exam findings summarized in the chart above.   
 
In May 2005, the CI underwent right ankle reconstruction surgery by arthroscopy (PEB dated    
24 February 2005).  The rehabilitation consult 2 months after to separation noted that the right 
ankle  joint  had  been  injected  three  times  with  cortisone  and  the  CI  required  a  cane  and 
ankle/foot supports for ambulation due to the sharp pain.  The exam findings are summarized 
in the chart above.  The VA Compensation & Pension examination, performed 3 months after 
separation,  noted  right  ankle  swelling,  stiffness;  weekly  flare-ups;  instability  and  give-way 
sensation,  fatigue  ability  and  lack  of  endurance;  precipitating  factors  of  prolonged  standing, 
ambulation or trying to jog which exacerbated pain and use of an ankle brace for ambulation.  
The  exam  findings  are  summarized  in the  chart  above  with  ROM  testing  including  additional 
functional loss due to pain. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  coded  the  right  ankle  condition  as  5099  analogous  to  5003  arthritis,  degenerative 
(hypertrophic  or  osteoarthritis)  rated  20%.    The  VA  coded  this  condition  5271  Ankle,  limited 
motion of:  marked and rated 20%.  All exams in evidence supported a 20% rating and the VA 
exam was following the post-PEB ankle surgery. 
 
The  Board  considered  that  the  coding  of  5099-5003  at  20%  would  require  “occasional 
incapacitating exacerbations” while the VA coding schema using 5271 focused on limitation of 
motion  which  would be  more  ideal  coding  for  the  right  ankle  condition.    Although  the  5271 
coding would be closer to “ideal,” neither coding is incorrect, nor would any change of coding 
increase the rating level or benefit the CI. 
 
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 posttraumatic osteochondritis desiccans, right talar dome 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.  As discussed above, PEB 
reliance on DoDI 1332.39 and VASRD for rating posttraumatic osteochondritis desiccans, right 
talar dome condition was operant in this case and the condition was adjudicated independently 
of that instruction by the Board.  In the matter of the posttraumatic osteochondritis desiccans, 
right talar dome and associated posttraumatic right ankle arthrosis conditions 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. 
 
 
 
 
 
 
 

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

UNFITTING CONDITION 

Posttraumatic Osteochondritis Desiccans, Rt Talar Dome (and 
Posttraumatic Right Ankle Arthrosis Cat 2) 

VASRD CODE  RATING 
5099-5003 
COMBINED 

20% 
20% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120228, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
  
 
 
 

 

           President 
           Physical Disability Board of Review 

   4                                                           PD1200214 
 

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL 
                                  OF REVIEW BOARDS  
 
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 
 
Ref:   (a) DoDI 6040.44 
             (b) CORB ltr dtd 26 Nov 12 
 
      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, 
for the reasons provided in their forwarding memorandum, approve the recommendations of 
the PDBR that the following individual’s records not be corrected to reflect a change in either 
characterization of separation or in the disability rating previously assigned by the Department 
of the Navy’s Physical Evaluation Board: 
 
                  -  former USN  
-  former USMC 
 
-  former USMC 
 
 
-  former USMC 
 
-  former USMC 
  
     
 
 
 
 
 

  
Assistant General Counsel 
(Manpower & Reserve Affairs) 

 
      
 

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