RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXXXXXXXXXXX                                                                       BRANCH OF SERVICE:  ARMY 
CASE NUMBER:  PD1200614                                                                   SEPARATION DATE:  20030704 
BOARD DATE:  20121106 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was a National Guard SPC/E-4 (11B/Infantryman), medically separated 
for traumatic arthritis of left ankle.  The CI required surgery after an ankle injury in 1986, but re-
injured it in February 2003.  The CI did not improve adequately with treatment  to meet the 
physical  requirements  of  his  Military  Occupational  Specialty  (MOS)  or  satisfy  physical  fitness 
standards.  He was issued a permanent L3 profile and referred for a Medical Evaluation Board 
(MEB).  The MEB forwarded traumatic arthritis of left ankle to the Physical Evaluation Board 
(PEB) as medically unacceptable IAW AR 40-501.  The MEB forwarded no other conditions for 
PEB  adjudication.    The  PEB  adjudicated  the  traumatic  arthritis  of  left  ankle  condition  as 
unfitting,  rated  10%  with  likely  application  of  the  Veteran’s  Affairs  Schedule  for  Rating 
Disabilities  (VASRD).    The  CI  made  no  appeals,  and  was  medically  separated  with  a  10% 
disability rating. 
 
 
CI CONTENTION:  “Unable to secure or follow a gainful unemployability.” [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 left 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  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  Army  Board  for 
Correction of Military Records. 
 
 
RATING COMPARISON: 
 

VA (2 Mos. Post-Separation) – All Effective Date 200307051 

Service IPEB – Dated 20030304 
Code 
Condition 
5010 

Traumatic Left Ankle Arthritis 

Rating 
10% 

 ↓No Additional MEB/PEB Entries↓ 

Condition 

Code 

Status Post Left Ankle Fracture 
Right Achilles Tendonitis 
Lumbar Spine Deg. Joint Disease 
Cervical Spine Deg Joint Disease 

5299-5271 
5299-5271 
5003-5242 
5003-5242 
0% X 1 / Not Service-Connected x 4 

Rating 
20%2 
20%2 
10%3 
10%3 

Exam 

20030826  
20030826 
20030826 
20030826 
20030826 

Combined:  10% 

Combined:  40% 

1Lumbar and cervical spine manifested within one year of discharge from service; effective date 20030826; combined 50% 
2Bilateral factor of 3.6 percent for diagnostic codes 5271, 5271 
3Rating decision 20080113 increased to 20% based on later exam; effective 20071004; combined 60% 
 
 

ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding  the  significant  impact  that  his  service-incurred  condition  has  had  on  his  current 
earning ability and quality of life.  It is a fact, however, 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.  This role and 
authority is granted by Congress to the Department of Veterans’ Affairs. 
 
Left Ankle Condition.  Open reduction internal fixation (ORIF) surgery of a left ankle fracture 
was required in 1986 due to injuries sustained in a motorcycle accident.  The CI subsequently 
did well until he sustained a twisting injury to the ankle on 12 February 2003 and experienced 
pain,  swelling  and  decreased  joint  motion.    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. 
 

Left Ankle ROM 

MEB ~4 Mo. Pre-Sep 

VA C&P ~ 2 Mos. Post-Sep 

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

Comment 

§4.71a Rating 

5⁰ 
5⁰ 
 

20% 

+Tenderness, abnormal gait 

-7⁰ 
40⁰ 

20% 

 
The narrative summary (NARSUM) exam performed on 26 February 2003 (4 months prior to 
separation) was performed only 2 weeks after the injury.  Examination showed the CI to move 
about the room without difficulty.  He could toe walk without difficulty but could not heel walk.  
X-rays showed orthopedic hardware in place with severe arthritic changes consistent with an 
essentially  fused  joint.    At  the  VA  Compensation  and  Pension  (C&P)  exam  performed  on 
26 August  2003  (2  months  after  separation),  the  CI  reported  ankle  pain exacerbated  by  cold 
weather and by walking one kilometer.  Flare ups resulted in an inability to walk due to pain.  
He was unable to participate in household chores.  He was taking an anti-inflammatory pain 
medication and used a one-point cane for walking assistance.  Examination showed no painful 
motion  and  no  signs  of  instability.    Because  of  limited  ankle  motion,  ambulation  resulted  in 
abnormal weight distribution towards the front of the foot; normal heel strike and stance phase 
of the gait cycle did not occur.  Another VA exam performed on 26 April 2004 (10 months after 
separation) confirmed the use of a one-point cane and a mild left lower extremity limp, and 
that he could walk an unlimited distance if his pace was slow. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
unfitting ankle condition was designated as existing prior to service (EPTS) by the PEB, but no 
deduction  was  applied.    The  PEB  assigned  a  10%  rating  under  the  5010  code  (traumatic 
arthritis)  with  likely  application  of  the  USAPDA  pain  policy.    The  VA’s  20%  rating  under  an 
analogous  5271  code  (ankle,  limited  motion  of)  was  based  on  a  “marked”  degree  of  motion 
impairment.  The Board considered that the substantial limitation of motion at the MEB exam 
was likely a sign of a very recent injury.  The VA exam, 6 months after injury, was more detailed 
and more reflective of a healed state; it was therefore assigned higher probative value.  Board 
members  noted  the  limitation  of  motion  at  the  time  of  separation,  and  the  ambulation 
difficulty with the need for an assistive device.  It was agreed that this degree of limited motion 
and impairment justified a 20% rating under a limitation of motion coding pathway.  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 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.  As discussed above, PEB 
reliance on the USAPDA pain policy for rating left ankle traumatic arthritis was operant in this 
case  and  the  condition  was  adjudicated  independently  of  that  policy  by  the  Board.    In  the 
matter  of  the  left  ankle  condition,  the  Board  unanimously  recommends  a  disability  rating  of 
20%, coded 5010 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 

5010 

COMBINED 

20% 
20% 

Traumatic Left Ankle Arthritis 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120606, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXXXXX 
           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 XXXXXXXXXXXXXXXXXX, AR20120021431 (PD201200614) 
 
 
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 to 20% 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 
 

     XXXXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)