RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

                               BRANCH OF SERVICE:  ARMY 
           SEPARATION DATE:  20020702 

 
NAME: XXXXXXXXXXXXXX                 
CASE NUMBER:  PD1200536                             
BOARD DATE:  20121030        
 
 
SUMMARY  OF  CASE:  Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty SPC/E-4 (91W/Medic) medically separated for a right 
ankle  condition.    He  developed  ankle  pain  in  2000,  which  was  ultimately  diagnosed  as 
osteochondritis dessicans; and, failed two attempts at surgical remedy.  He was unable to meet 
the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness 
standards; was issued a permanent L3 profile; and, was referred for a Medical Evaluation Board 
(MEB).    The  condition  was  forwarded  to  the  Physical  Evaluation  Board  (PEB)  as  medically 
unacceptable  IAW  AR  40-501.    No  other  conditions  were  submitted  by  the  MEB.    The  PEB 
adjudicated  the  right  ankle  condition  as  unfitting,  rated  10%,  citing  criteria  of  the  Veteran’s 
Administration  Schedule  for  Rating  Disabilities  (VASRD).    The  CI  made  no  appeals,  and  was 
medically separated with that disability rating. 
 
 
CI  CONTENTION:  The  application  states:  “My  right  ankle  is  in  constant  pain  that  never 
completely  subsides.    I  have  been  on  numerous  pain  control  medication  combinations  both 
over-the-counter and prescription.  I cannot run.  My joint range of motion is severely limited I 
have  a  VA  prescribed  brace  that  I  must  wear  for  joint  stability.    There  are  days  where  just 
walking can be a chore.”  The CI’s narrative continues with a description of the impairments he 
suffers  from  tinnitus  (contending  for  separate  ratings  for  each  ear),  chronic  sinusitis,  and 
“debilitating” headaches.  
 
 
SCOPE  OF  REVIEW:    The  Board  wishes  to  clarify  that  the  scope  of  its  review  as  defined  in 
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  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.    The  additionally  requested  conditions  (tinnitus,  chronic  sinusitis,  and  headaches) 
were not identified by the PEB, and thus are not within the DoDI 6040.44 defined purview of 
the  Board.    Those,  and  any  conditions  or  contention  outside  the  Board’s  defined  scope  of 
review, remain eligible for future consideration by the Army Board for Correction of Military 
Records.  
 
The Board acknowledges the CI’s information regarding the significant impairment with which 
his  service-connected  conditions  continue  to  burden  him;  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 
Veterans’  Affairs  (DVA),  operating  under  a  different  set  of  laws.    The  Board  considers  DVA 
evidence  proximate  to  separation  in  arriving  at  its  recommendations;  and,  DoDI  6040.44 
defines  a  12-month  interval  for  special  consideration  to  post-separation  evidence.    All  post-

separation  evidence  is  probative  to  the  Board’s  recommendations  only  to  the  extent  that  it 
reasonably reflects the disability at the time of separation. 
 
RATING COMPARISON:  
 

Service PEB – Dated 20020502 

Condition 

Code 

Chronic Right Ankle Pain... 

5299-5003 

Rating 
10% 

No Additional MEB/PEB Entries 

Combined:  10% 

 

VA (1 Mo. Pre-Separation) – Effective Date 20020703 

Condition 

Right Ankle Osteochondritis... 
Tinnitus 

Code 
5271 
6260 
0% X 1 / Not Service Connected x 4 

Rating 
10% 
10% 

Exam 

20020617 
20020617 
20020617 

Combined: 20% 

 

imaging. 

ANALYSIS SUMMARY:  
 
Right  Ankle  Condition.    The  CI  experienced  an  onset  of  right  ankle  pain  and  swelling  with 
running  in  May  2000.    The  symptoms  worsened;  initial  radiographs  were  negative;  and,  the 
condition  was  managed  conservatively.    Computed  tomography  in  August  2000  revealed  an 
osteochondral  defect  of  the  talar  dome,  and  orthopedics  prescribed  a  period  in  a  non-
weightbearing (NWB) cast; but, follow-up imaging revealed a persistent defect.  In January 2001 
arthroscopic surgical intervention and another course of NWB was undertaken; but, was met 
with  continued  symptoms  and  persistent  defect  on 
  A  second  arthroscopic 
intervention performed in July 2001 followed by a third trial of NWB, yielded similar results; 
and,  the  MEB  was  initiated.    The  narrative  summary  (NARSUM)  noted  persistent  pain  and 
inability “to lift and carry patients, kneel or squat, crawl, walk on uneven terrain, run, or wear a 
rucksack.”  The physical exam noted “visible swelling” and lateral tenderness.  There was no 
comment  on  gait,  but  outpatient  notes  do  not  reflect  abnormal  gait  or  use  of  assistive 
ambulatory device.  The range-of-motion (ROM) recorded in the NARSUM was dorsiflexion 10 
degrees (normal 20 degrees and plantar flexion 30 degrees (normal 45 degrees).  An orthopedic 
addendum to the NARSUM noted a similar history and physical exam, recording dorsiflexion 10 
degrees and plantar flexion 45 degrees.  The VA Compensation and Pension (C&P) exam was 
not available for review, but was adequately summarized in the rating decision: “VA examiner 
noted pain on motion limiting participation in athletics, but there was no significant limitation 
of range of motion.  You reported at the VA exam that there is continual pain and swelling in 
the ankle.” 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB’s  10%  rating  analogously  to  5003  (degenerative  arthritis)  cited  “loss  of  motion;”  which 
complies  with  the  VASRD  §4.71a  language under  5003  directing  a  10%  rating for  “each  such 
major joint or group of minor joints affected by limitation of motion.”  The VA’s 10% rating was 
under code 5271 (ankle limitation of motion) for ‘moderate’ limitation.  There is no available 
alternate ankle joint code which would yield a higher rating; in the absence of ankylosis (frozen 
joint), malunion, or astragalectomy (surgical removal of the talus).  The only route to a higher 
rating would be 20% under 5271 for ‘marked’ limitation of motion.  Members agreed that the 
preponderance of the ROM evidence was more reasonably characterized as ‘moderate.’  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 of 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.  In the matter of the right ankle 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: 
 

 

Chronic Pain and Surgical Residuals, Right Ankle 

UNFITTING CONDITION 

VASRD CODE  RATING 
5299-5003 
COMBINED 

10% 
10% 

 

 

The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120602, w/atchs. 
Exhibit B.  Service Treatment Record. 
Exhibit C.  Department of Veterans’ Affairs Treatment Record. 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXXXXXX 
           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 
XXXXXXXXXXXXXXXXXXX, AR20120020919 (PD201200536) 
 
 
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 
 
 
 
CF:  
(  ) DoD PDBR 
(  ) DVA 

     XXXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)