RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:   MARINE CORPS 
 
SEPARATION DATE:  20030131 

 
NAME:  XX 
CASE NUMBER:  PD1200874 
BOARD DATE:  20130220 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  PFC/E-2  (1371/Basic  Combat  Engineer),  medically 
separated for osteochondritis desiccans Grade II to III with articular and cortical bone defect of 
the  right  ankle.    Despite  limited  duty  (LIMDU)  and  physical  therapy  (PT)  he  could  not  be 
adequately  rehabilitated  to  meet  the  physical  requirements  of  his  Military  Occupational 
Specialty (MOS) or satisfy physical fitness standards.  He was placed on LIMDU and referred for 
a Medical Evaluation Board (MEB).  Avascular necrosis condition, identified in the rating chart 
below,  was  also  identified  and  forwarded  by  the  MEB.    The  Physical  Evaluation  Board  (PEB) 
adjudicated the right ankle condition as unfitting, rated 10% with application of the Veteran’s 
Affairs Schedule for Rating Disabilities (VASRD).  The remaining condition was determined to be 
Category II, a condition that contributes to the unfit condition.  The CI made no appeals and 
was medically separated with a 10% 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 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 Board for Correction of Naval Records. 
 
 
RATING COMPARISON:   
 

Service IPEB – Dated 20021125 
Condition 
Code 
5271 

Osteochondritis Desiccans w/ 
Articular & Cortical Bone Defect 
Avascular Necrosis 

No Additional MEB/PEB Entries 

Combined:  10% 

Rating 
10% 

Category II 

VA (2 Mos. Post-Separation) – All Effective Date 20030201 
Exam 

Condition 

Code 
5271 

Rating 
10%* 

Residuals Fracture, Rt Ankle w 
Degenerative Disease 

No Corresponding VA Entry 

4 Other Conditions 

Combined: 50%* 

20030409 

20030409 

*Original VARD rated the condition as Residual Cortical Deformity of the Posterior Malleolus and Posttraumatic Calcification in 
the Lower Interosseous Membrane, Rt Ankle coded 5299-5271 at 0% also with a combined rating or 0%.  VARD dated 20040311 
resulted in the right ankle rating and coding noted above.  Four other previously not service connected conditions were added 
at 10% ratings each retroactive to date of separation, resulting in the 50% combined rating.  
 
 
 

 

ANALYSIS SUMMARY:   
 
Right Ankle Condition.  The MEB narrative summary (NARSUM) reported that the CI injured his 
right ankle on 1 March 2002 during basic training.  Initial X-ray examinations were normal.  The 
CI was on a brief period of limited duty for treatment.  He completed training but continued to 
complain  of  pain.    While  on  leave,  an  X-ray  performed  six  or  more  weeks  after  the  injury 
demonstrated evidence of a healing fracture with copious callous formation of the distal tibia 
(shin bone) at the ankle.  Repeat X-ray of the right ankle on 19 July 2002 at the CI’s next duty 
station confirmed a healing fracture of the distal lateral tibia.  The CI was placed on LIMDU for 
several weeks but continued to experience pain.  A bone scan of the right ankle on 13 August 
2002  revealed  injury  to  right  distal  tibia  metaphysis,  at  the  level  of  the  posterior  malleolus.  
Magnetic  resonance  imaging  (MRI)  on  16  September  2002  revealed  a  Grade  II  to  III 
osteochondritis  dissecans  to  the  posterior  malleolus  over  the  right  ankle  with  articular  and 
cortical bone defect (avascular necrosis).  There were cystic changes and fairly extensive bone 
marrow edema.  The MEB physical exam on 27 September 2002, 4 months prior to separation, 
noted unspecified decreased range of motion with plantar flexion and tenderness to palpation 
(TTP)  of  the  posterior  aspect  of  the  distal  lateral  right  tibia.    The  exam  was  noted  to  be 
otherwise noncontributory.  At the VA Compensation and Pension (C&P) examination on 9 April 
2003,  2  months  after  separation,  the  CI  reported  having  difficulty  walking  long  distances, 
climbing stairs, shopping, and mowing the lawn.  He was working as a scrub nurse technician 
and denied occupational limitations.  The examiner noted that the CI had normal posture and 
gait.  There was no evidence of callosity, breakdown, weight-bearing line, or tenderness.  The CI 
was not using an assistive device.  The right dorsiflexion range-of-motion (ROM) was 20 degrees 
and plantar flexion was 45 degrees, both within normal limits.  The examiner noted that the CI 
was without pain on ROM testing.  The examiner also noted the left leg was a centimeter longer 
than the right.  X-ray examination of the right ankle on 9 April 2003 revealed post traumatic 
calcification within the lower interosseous membrane and evidence of an old injury of posterior 
malleolus but without post traumatic arthritic change, osteochondritis, joint effusion or other 
signs of instability.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB rated the ankle condition using the code 5271, limited motion of ankle with 10% disability.  
The VA initially used an analogous coding, 5299-5271 with a 0% disability, but on appeal rated 
the ankle 10% based on painful motion IAW VASRD §4.59 (coded 5271).  The Board considered 
alternative  VASRD  ankle  and  analogous  codes,  but  all  were 
less  applicable  and  not 
advantageous  to  rating.    The  Board  considered  VASRD  code  5262,  impairment  of  tibia  and 
fibula and agreed that there was no evidence to support rating higher than a 10%.  The Board 
also considered the use of code 5275, for shortening of the lower extremity, however the non-
affected leg was shorter and the discrepancy would not attain a minimum rating.  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 for 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.   
 
 

2                                                           PD1200874 

RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows:   
 

UNFITTING CONDITION 

Osteochondritis Desiccans grade II to III w/ Articular & Cortical 
Bone Defect Right Ankle 

VASRD CODE  RATING 

5271 

COMBINED 

10% 
10% 

  
 
 
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 
 
 
 
 
 
 
 
 

 
 
 

 

xx 
Acting Director 
Physical Disability Board of Review 

3                                                           PD1200874 

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 22 Mar 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 
-   former USMC 
  

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

4                                                           PD1200874