RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:   NAVY 
SEPARATION DATE:  20040307 

 
NAME:    
CASE NUMBER:  PD1200345 
BOARD DATE:  20121116 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  AC2/E-5  (AC2/Air  Traffic  Controller),  medically 
separated for chronic right ankle instability (5299-5003).  The CI did not improve adequately 
with  surgical  treatment  to  meet  the  physical  requirements  of  his  rating  or  satisfy  physical 
fitness standards.  He was placed on both light duty and limited duty and referred for a Medical 
Evaluation  Board  (MEB).    Chronic  ankle  pain,  identified  in  the  rating  chart  below,  was  also 
identified  and  forwarded  by  the  MEB.    The  Physical  Evaluation  Board  (PEB)  adjudicated  the 
chronic  ankle  instability  condition  as  unfitting,  rated  10%,  with  application  of  the  Veteran’s 
Affairs Schedule for Rating Disabilities (VASRD).  The remaining condition, chronic ankle pain, 
was  determined  to  be  not  unfitting  and  determined  to  be  Category  II  (associated  with  the 
unfitting  condition  but  not  separately  ratable).    The  CI  made  no  appeals,  and  was  medically 
separated with a 10% disability rating.   
 
 
CI CONTENTION:  In Item 3, the CI Contends, “My personal health has taken a turn since the 
injury.  I have gained weight; have sleep apnea, anxiety, and other disorders.”   
 
 
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 condition meets 
the criteria prescribed in DoDI 6040.44 for Board purview, and is accordingly addressed below.  
The  remaining  conditions  rated  by  the  VA  at  separation  and  listed  on  the  DD  Form  294 
application 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:   
 

VA – All Effective Date 20040308 

Exam 
STR 

STR 

Service IPEB – Dated 20031114 
Condition 

Code 

Chronic R Ankle Instability 
Chronic R Ankle Pain 

5299-5003 

Cat II 

Rating 
10% 

Condition 

Chronic Instability, Right Ankle 

Code 
5271 

Rating 
20% 

↓No Additional MEB/PEB Entries↓ 

0% X 3 / Not Service-Connected x 5 

Combined:  10% 

Combined:  20% 

 

 
 
 
 

ANALYSIS SUMMARY:  The Disability Evaluation System (DES) is responsible for maintaining a fit 
and  vital  fighting  force.    While  the  DES  considers  all  of  the  member's  medical  conditions, 
compensation  can  only  be  offered  for  those  medical  conditions  that  cut  short  a  member’s 
career, and then only to the degree of severity present at the time of final disposition.  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  nor  for  conditions 
determined  to  be  service-connected  by  the  Department  of  Veterans  Affairs  (DVA)  but  not 
determined to be unfitting by the PEB.  However the DVA, operating under a different set of 
laws  (Title  38,  United  States  Code),  is  empowered  to  compensate  all  service-connected 
conditions  and  to  periodically  re-evaluate  said  conditions  for  the  purpose  of  adjusting  the 
Veteran’s disability rating should the degree of impairment vary over time.  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.   
 
Chronic  Right  Ankle  Instability  Associated  with  Chronic  Ankle  Pain  Condition.    The  CI  had  a 
history  of  repeated  right  ankle  injuries  in  February  1999  and  September  2000  resulting  in 
chronic ankle pain diagnosed as chronic sprain by an orthopedic surgeon.  Arthroscopic surgery 
of the right ankle performed in May 2001 included excision of a loose joint body debridement 
of  synovitis,  and  a  lateral  ankle  reconstruction.    He  had  persisting  pain  with  running.    On 
23 January 2003, his primary care doctor noted decreased range-of-motion (ROM).  The MEB 
narrative  summary  (NARSUM  )  performed  on  7  April  2003,  11  months  before  separation, 
documented  CI  had  chronic  right  ankle  pain  status  post  surgery.    The  MEB  NARSUM 
examination was normal except for “decrease of range of motion and strength in right ankle.”  
No  goniometric  ROM  or  gait  observation  was  reported.    On  7  May  2003,  a  month  later, 
“severe”  ROM  limitations  were  noted  of  the  ankle  by  family  practice.    No  goniometric 
measurements or mention of an antalgic or limping gait were found in the service treatment 
record (STR).  No VA Compensation and Pension (C&P) examination proximate to separation is 
in  evidence  (VARD  states  CI  did not  show for his  scheduled examination  in  June 2004).   The 
Board directs attention to its rating recommendation based on the above evidence.  The PEB 
assigned a 10% rating under the VASRD 5299-5003 code (traumatic arthritis).  The VA’s 20% 
rating  under  the  5271  code  (ankle,  limited  motion  of)  was  based  on  a  “severe”  ROM 
impairment as noted in the STR.  The Board considered whether the ankle impairment more 
nearly approximated the moderate (10%) or marked (20%) impairment under diagnostic code 
5271  (limited  motion).    While  there  were  no  goniometric  measurements  of  the  ankle,  all 
examinations reported limited motion which was characterized as severe by one examiner.  The 
Board also considered the duty limitations of no prolonged walking or standing and CI report of 
inability to climb the 10 flights of stairs to the control tower the condition imposed by pain.  In 
the absence of evidence to the contrary, the Board agreed that the degree of limited motion 
and  functional  impairment  due  to  pain  justified  a  20%  rating  under  code  5271.    The  Board 
concluded there were no other reasonable coding options for rating.  After due deliberation, 
considering  all  of  the  evidence  and  mindful  of  VASRD  §4.3  (reasonable  doubt),  the  Board 
recommends  a  disability  rating  of  20%  for  the  right  chronic  ankle  instability  condition  with 
residuals of pain (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.    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 chronic right ankle instability associated with chronic ankle 
pain condition, the Board by a vote of 2:1 recommends a disability rating of 20%, coded 5271 
IAW  VASRD  §4.71a.    The  single  voter  for  dissent  (who  recommended  no  change  to  the  PEB 

   2                                                           PD12-00345 

adjudication) submitted the appended minority opinion.  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 

20% 
20% 

Chronic Ankle Instability 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120328, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
  
 
 
 

 

           President 
           Physical Disability Board of Review 

   3                                                           PD12-00345 

MINORITY OPINION:   
 
The  Board  members  deliberated  between  a  10%  and  20%  for  a  final  disposition.  After  a 
thorough review and examination of the whole recorded history, I believe the final rating of 
10%, as rated by the PEB, accurately reflects the elements of the CIs disability at the time of his 
separation.   
 
There is not a sufficient amount of evidence in the CI’s treatment records to present a “severe” 
ROM impairment to warrant a higher disability rating of 20%.  The MEB NARSUM exam was 
normal except for a “decrease of range of motion and strength in right ankle.”  There were no 
goniometric  ROMs  or  gait  observation  reported.    The  only  note  in  the  STR  that  recorded  a 
“severe” ROM limitation of the ankle was on 7 May 2003, by family practice.  There were no 
goniometric measurements or mention of an antalgic or limping gait in the service treatment 
record.   
 

 

   4                                                           PD12-00345 

MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS 
                                        COMMANDER, NAVY PERSONNEL COMMAND 
 
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 
 
Ref:   (a) DoDI 6040.44 
          (b) PDBR ltr dtd 17 Dec 12  
          (c) PDBR ltr dtd 5 Dec 12  
          (d) PDBR ltr dtd 11 Dec 12  
          (e) PDBR ltr dtd 26 Nov 12  
          (f) PDBR ltr dtd 20 Nov 12  
                               
1.  Pursuant to reference (a) I approve the recommendations of the Physical Disability Board of 
Review set forth in references (b) through (f). 
 
2.    The  official  records  of  the  following  individuals  are  to  be  corrected  to  reflect  the  stated 
disposition: 
 
     a.    former USMC:  Disability separation with a final disability rating of 20 percent (increased 
from 10 percent) with entitlement to disability severance pay. 
 
     b.    former USMC:  Disability separation with a final disability rating of 10 percent (increased 
from zero percent) with entitlement to disability severance pay.  
 
     c.    former USN:  Disability separation with a final disability rating of 20 percent (increased 
from 10 percent) with entitlement to disability severance pay. 
 
     d.  former USN:  Disability separation with a final disability rating of 20 percent (increased 
from 10 percent) with entitlement to disability severance pay. 
 
     e.  former USMC:  Disability separation with a final disability rating of 20 percent (increased 
from 10 percent) with entitlement to disability severance pay. 
 
3.    Please  ensure  all  necessary  actions  are  taken,  included  the  recoupment  of  disability 
severance  pay  if  warranted,  to  implement  these  decisions  and  that  subject  members  are 
notified once those actions are completed. 
 
 
 
 
 
 
 

 
Assistant General Counsel 
Manpower & Reserve Affairs) 

 

   5                                                           PD12-00345