RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXXXXXXXXXXXXX                                                                      BRANCH OF SERVICE: ARMY  
CASE NUMBER:  PD1200316 
SEPARATION DATE:  20060123 
BOARD DATE:  20121102 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty SPC/E-4 (25F/Network Switching Operator), medically 
separated for chronic right ankle pain.  The CI had a sprain in 2003 with ligamentous laxity.  On 
1  February  2005  he  had  surgical  repair  with  good  stability,  but  persistent  pain  refractory  to 
treatment.  The CI did not meet the physical requirements of his Military Occupational Specialty 
or satisfy physical fitness standards.  He was issued a permanent L3 profile and referred for a 
Medical Evaluation Board (MEB).  The MEB forwarded chronic right ankle pain to the Physical 
Evaluation Board (PEB).  No other conditions were forwarded for PEB adjudication.  The PEB 
adjudicated the chronic right ankle pain condition as unfitting, rated 0%, with application of the 
US  Army  Physical  Disability  Agency  (USAPDA)  pain  policy.    The  CI  appealed  directly  to  the 
USAPDA, which affirmed the PEB findings.  He was then medically separated with a 0% disability 
rating.   
 
 
CI CONTENTION:  The CI elaborated no specific contention in his application.   
 
 
SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in the 
Department of Defense Instruction (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.  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 PDA – Dated 20060109 

VA (4 Mos. 4 Post-Separation) – All Effective Date 20060130 

 
 
ANALYSIS SUMMARY:   
 
Chronic  Right  Ankle  Pain.    The  first  visit  for  right  ankle  in  the  record  was  performed  on  
2  April  2002  after  he  sprained  his  right  ankle.    He  was  treated  with  an  ace  wrap  and  duty 
limitations.  He was seen again in 2004 for chronic right ankle pain.  X-rays performed on 23 July 
2004 were normal.  An magnetic resonance imaging (MRI) performed on 18 October 2004 was 

Condition 

Chronic Right Ankle Pain 

Code 

5099-5003 

Rating 

0% 

↓No Additional MEB/PEB Entries↓ 

Combined:  0% 

Condition 

Right ATFL Strain  
Osgood-Schlatter’s Disease 

5299-5261 
0% X 1 / Not Service-Connected x 2 

Combined:  20% 

Code 
5271 

Rating 
10% 
10% 

Exam 

20060506 
20060506 
20060426 

suggestive of strain of the anterior tibiofibular ligament (ATFL).  An orthopedics evaluation, for 
persistent pain, performed on 19 January 2005 was significant for a positive anterior drawers 
and  talar  tilt.    He  underwent  a  Bronstom  repair  of  the  ATFL  and  regained  stability,  but  had 
persistent pain despite physical therapy.  He did have improvement in his ROM with treatment, 
though.  An orthopedic note on 25 April 2005, 9 months prior to separation, noted dorsiflexion 
of 15 degrees and normal plantar flexion at 45 degrees.  His ankle remained stable.  He was 
seen again in orthopedics on 22 July 2005 and 14 October 2005 with persistent pain.  He was 
recommended  for  MEB  at  the  latter  appointment.    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 
Degrees 

Dorsiflexion (0-20) 
Plantar Flexion (0-45) 

Comments 

 

MEB ~2 Mo. Pre-Sep 

VA C&P ~4 Mo. Post-Sep 

Left 
10 
35 

 

Right 

5 
30 

R ankle negative anterior drawer 
and talar tilt test.  No additional 
loss of motion with repetition 

Left 
- 
- 

 

Right 

0 
30 

No instability to varus or valgus 
stress; no pain with repetitive 
motion.  Sub-talar motion 20 

degrees 

10% 

N/A 

10% 

§4.71a Rating 

N/A 

 
At the MEB exam performed on 1 November 2005, the CI reported pain and swelling of the 
right ankle.  The MEB physical examiner noted lateral swelling and reduced ROM.  The ROM 
was  measured  2  weeks  later  in  physical  therapy  and  is  in  the  table  above.    The  narrative 
summary  (NARSUM)  was  dictated  23  November  2005,  2  months  prior  to  separation.    The  CI 
noted constant pain, but took no medications for it.  No separate examination was performed.  
At  the  VA  Compensation  and  Pension  (C&P)  exam  performed  on  6 May  2006,  a  little  over  3 
months after separation, the CI reported daily pain without flares.  He was limited in running, 
but  could  stand  for  3-4  hours  and  walk  a  mile.    He  used  no  assistive  devices  and  had  no 
limitations in activities of daily living including recreation.  On examination, he had swelling and 
tenderness over the ATFL.  Gait was non-antalgic.  He had painless ROM and could rise on his 
toes  without  difficulty.    There  was  no  instability  or  malalignment.    X-rays  showed  medial 
calcification with an intact ankle mortise.  He was thought to have peroneal tendonitis.  The 
Board directs attention to its rating recommendation based on the above evidence.  The PEB 
rated  the  ankle  at  0%  disability  and  coded  it  5099-5003,  analogous  to  degenerative  arthritis 
using  the  PDA  pain  policy.    The  VA  coded  the  ankle  5271  and  rated  it  10%  for  moderate 
limitations  in  ROM.    The  Board  considered  other  coding  options,  but  concluded  that  none 
offered an advantage to the CI or were better descriptors of the condition than 5271 and that 
the limitation in ROM was best described as moderate, which supports a rating of 10%.  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 coded 5271.   
 
 
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 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  5271  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 his prior medical separation:   
 

UNFITTING CONDITION 

VASRD CODE  RATING 

5271 

COMBINED 

10% 
10% 

Chronic Right Ankle Pain 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120322, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

 
 

 
 
 

 
 
 

 
 
 

 
 
 

 
 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB /  ), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for XXXXXXXXXXXXXXXXXXXX, AR20120020616 (PD201200316) 
 
 
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 t0 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 
 
 
 
CF:  
(  ) DoD PDBR 
(  ) DVA 
 

     XXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)