RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

Code 
5271 

Exam 
STR 
 

 

BRANCH OF SERVICE:  MARINE CORPS 
SEPARATION DATE:  20011231 

 
NAME:  XX 
CASE NUMBER:  PD1200545 
BOARD DATE:  20130201 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  L.Cpl./E-3  (9900/Recruit),  medically  separated  for 
osteochondritis dissecans, left posteromedial talus, surgically treated twice.  The CI sustained 
an  ankle  sprain  on  11  October  2000,  3  months  after  accession,  and  was  found  to  have  an 
osteochondral fracture on X-ray.  Conservative management was unsuccessful and on 8 January 
2001, she underwent chrondroplasty.  Despite rehabilitation, she developed chronic pain and 
underwent  open  debridement  on  30  May  2001.    The  CI  did  not  improve  adequately  with 
treatment to meet the physical requirements of her Military Occupational Specialty or satisfy 
physical  fitness  standards.    She  was  referred  for  a  Medical  Evaluation  Board  (MEB).  
“Osteochondritis  dissecans,  left  posteriomedial  talus,  operated  x  2”  was  forwarded  to  the 
Physical Evaluation Board (PEB).  The MEB forwarded no other conditions for adjudication.  The 
PEB  adjudicated  “Osteochondritis  dissecans,  left  posteriomedial  talus,  operated  x  2”  as 
unfitting,  rated  10%,  with  application  of  the  Veterans  Affairs  Schedule  for  Rating  Disabilities 
(VASRD).  The CI made no appeals and was medically separated with a 10% disability rating.   
 
 
CI CONTENTION:  “Since I was separated I had 2 additional surgeries [SP], 2 spinal injections 
several different medications & years of PTSD therapy.  I have problems falling asleep & staying 
asleep I have nightmares I have lost range of motion in my Left-ankle I have nerve damage in 
result to my surgeries (The pain & loss of feeling is moving up my limb I have arthritus [SP] in 
my Left ankle I have had Knee Surgery on my left Knee in order to take needed cartlidge [SP] 
and place in my left ankle.” 
 
 
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 osteochondritis dissecans condition, 
as requested for consideration, meets the criteria prescribed in DoDI 6040.44 for Board purview 
and is addressed below.  The other requested conditions [PTSD, sleep disturbance, nightmares, 
nerve  damage,  arthritis,  left  Knee]  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:   
 

Service IPEB – Dated 20011024 
Condition 
OCD, Left ankle 
↓No Additional MEB/PEB Entries↓ 
Combined:  10% 
*Increased to 20% effective 20070201.  Post-surgical temporary 100% x 2 on 20060814 and 20070920 for convalescence 
 

VA (~1 Mo. Post-Separation) – All Effective Date 20020101 
Condition 
Residuals of Left Ankle Fracture 
0% X 1 / Not Service-Connected x 4 
Combined:  10% 

Code 
5299-5003 

Rating 
10% 

Rating 
10%* 

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.    The  Board  utilizes  DVA  evidence  proximal  to  separation  in  arriving  at  its 
recommendations; and, DoDI 6040.44 defines a 12-month interval for special consideration to 
post-separation evidence.  The Board’s authority as defined in DoDI 6044.40, however, resides 
in evaluating the fairness of DES fitness determinations and rating decisions for disability at the 
time of separation.  Post-separation evidence therefore is probative only to the extent that it 
reasonably reflects the disability and fitness implications at the time of separation. 
 
Osteochondritis Dissecans, Left Posteromedial Talus, Operated x 2 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.   
 

Ortho ~6 Mos. Pre-Sep 

OT ~4 Mos. Pre-Sep 

MEB ~3 Mos. Pre-Sep 

  + 

Dorsiflexion (0-20) 
Plantar Flexion (0-45) 
Comment 
§4.71a Rating 

Left 

Right 

Left 

Right 

 
 

0 
10 
Five weeks post op 
20% 

 

50 
50-- 
10 
20-- 
Ambulation pain free 
10% 

-- 

Left 

20 
20 
 
10% 

Right 

30 
30 
 
-- 

Note: VA C&P Exam dated 20030916 is the closest VA C&P Exam closest to DOS p. 53.  It is 21 months post-separation 
 
The  CI  sustained  a  left  ankle  sprain  and  was  found  to  have  an  osteochondral  defect  of  the 
medial talar dome  with a  small  avulsed  fragment.    She  failed  conservative  management  and 
was  treated  with  arthroscopic  debridement  and  drilling  of  the  cartilage  on  8  January  2001.  
Despite  continued  rehabilitation,  she  had  continued  pain  and  had  open  debridement  on 
30 May  2001.    Post-operatively,  she  noted  numbness  of  the  left  foot,  but  electrophysiologic 
studies were normal.  She continued to have problems with impact activities and biking.  The 
narrative  summary  dictated  on  24  September  2001,  3  months  before  separation,  by  her 
treating orthopedic surgeon and 4 months after her second surgery.  The CI reported she was 
comfortable walking, but had a deep ache in her ankle with increased activity like running or 
biking.  She also noted pain with barometric changes.  Her incision was well healed.  The ROM 
measurements are above.  The examiner also noted that subtalar motion was slightly restricted 
on the left.  At the MEB examination a week later on 2 October 2001, the CI reported pain with 
10-15 minutes of walking.  On examination, she had normal strength and was without laxity.  
The ROM was full.  Some edema was noted.  There was not a VA Compensation and Pension 
(C&P) exam until 21 months after separation.  The CI noted continued pain and that walking 
was limited to 5-10 minutes.  On examination, she had a normal gait.  The ankle was slightly 
swollen compared to the right.  The ROM was slightly decreased from the last ROM on active 
duty at 15 degrees dorsiflexion and 30 degrees plantar flexion.  There was no tenderness and 
the drawers was negative (normal).   

   2                                                           PD1200545 
 

The Board directs attention to its rating recommendation based on the above evidence.  The VA 
based its initial rating on the service records.  Both the PEB and VA rated the ankle at 10%, but 
coded it 5299-5003 (analogous to degenerative arthritis) and 5271 (limited ROM of the ankle), 
respectively.  The Board considered these codes as well as other codes available for the ankle.  
None offered a route to a higher rating that that assigned by the PEB.  After due deliberation, 
considering all of the evidence and mindful of VASRD §4.3 (Resolution of reasonable doubt), the 
Board  concluded  that  there  was  insufficient  cause  to  recommend  a  change  in  the  PEB 
adjudication for the left 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 left 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 there be no recharacterization of the 
CI’s disability and separation determination, as follows:   
 

UNFITTING CONDITION 
Osteochondritis Dissecans, Left Posteromedial Talus, Operated x 2 

VASRD CODE  RATING 
5299-5003  
RATING 

10% 
10% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120603, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

           xx 
           Acting Director 
           Physical Disability Board of Review 

   3                                                           PD1200545 
 

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 Feb 13 
 

      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 USMC 
-   former USN  
-   former USMC 
-   former USMC 
-   former USN  
-   former USMC 
  
 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

   4                                                           PD1200545