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AF | PDBR | CY2013 | PD-2013-02077
Original file (PD-2013-02077.rtf) Auto-classification: Approved
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX    CASE: PD-2013-02077
BRANCH OF SERVICE: Army  BOARD DATE: 20141009
SEPARATION DATE: 20050508

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an activated Reserve PV2/E-2 (88M10/Transportation Operator) medically separated for an ankle condition. The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty or satisfy physical fitness standards. He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). The ankle condition, characterized as “chronic left ankle pain” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The Informal PEB adjudicated “chronic left ankle pain” as unfitting, rated 0%, citing criteria of the US Army Physical Disability Agency (USAPDA) pain policy. The CI made no appeals and was medically separated.


CI CONTENTION: “Because at time of MEB, all conditions wasn’t (sic) considered. At the time I went through my MEB, I was met with harsh treatment mentally from higher ranked persons. I met people there in Ft Bragg that displayed their dislike of me because I was injured and getting out. I never wanted to get out of military, but was forced out with NO information on what was going on.”


SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2). It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI. The rating for the unfitting ankle condition is addressed below; and, no additional conditions are within the DoDI 6040.44 defined purview of the Board. IAW DoDI 6040.44, the Board’s authority is limited to making recommendations on correcting disability determinations. The Board’s role is thus confined to the review of medical records and all evidence at hand to assess the fairness of PEB rating determinations, compared to the VA Schedule for Rating Disabilities (VASRD) standards, based on ratable severity at the time of separation. 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 Military Records.


 RATING COMPARISON :

Service IPEB – Dated 20050411
 VA – 26 Mos. Post-Separation
Condition
 Code Rating Condition Code Rating Exam
Chronic Left Ankle Pain 5099-5003 0% Left Ankle Condition 5271 NSC* STR
Other x 0 (Not in Scope)
 Other x 7
Rating: 0%
 Rating: NSC
Derived from VA Rating Decision (VA RD ) dated 200 70706 (most proximate to date of separation [ DOS ] ).
*20110810 VARD determined 10% effective 20070227 (21 Mos. Post-Separation).


ANALYSIS SUMMARY:

Chronic Left Ankle Pain. According to the MEB narrative summary (NARSUM) the CI incurred a left ankle sprain in basic training (2003) which had resolved. Just prior to receiving orders activating him to active duty for Operation Noble Eagle, the CI completed an Initial Medical Review - Annual Medical Certificate form performed on 6 May 2004, reporting “I have recently fractured a bone in both ankles (11/03). This has been occurring for some time now.” A sick slip from his Reserve unit clinic performed on 1 June 2004, recorded left ankle pain and right foot pain. Sick slips, both dated 18 June 2004, recorded left ankle pain and swelling after running with prior sprain and pain and swelling of the left ankle for 7 months. An X-ray of the left ankle, performed on 18 June 2004 noted a focal area of degenerative change affecting the medial malleolus but was otherwise normal. The CI was activated to active duty on 7 June 2004. Following activation, the CI reported recurrent left ankle pain with running but without specific injury. Orthopedic examination performed on 26 July 2004 noted swelling and tenderness of the left ankle. Dorsiflexion was 10 degrees, plantar flexion was 38 degrees and subtalar motion (eversion and inversion) was full without pain. Magnetic resonance imaging of the left ankle performed on 7 August 2004 was normal showing intact ligaments, normal bone and normal joints. The MEB NARSUM performed on 11 February 2005, recorded ankle tenderness with a slight antalgic gait. The physical therapy MEB examination dated 25 February 2005, recorded active left ankle range of motion dorsiflexion of 0 degrees (right ankle was 15), plantar flexion 40 (right 45), inversion 15 (right 20) and eversion 0 (right 0). There was no VA Compensation and Pension (C&P) examination proximate to the date of separation.

The Board directs attention to its rating recommendation based on the above evidence. The PEB rated the chronic left ankle pain 0% (coded 5099-5003) with application of the USAPDA pain policy. The VA subsequently granted a 10% service-connected rating for the left ankle (coded 5271, limited motion of the ankle) effective on 27 February 2007. The MEB physical therapy examination recorded loss of dorsiflexion but with near normal plantar flexion supporting a 10% rating for moderate limitation of motion (5271 ankle, limited motion). The Board noted that while the limitation of motion may not reach the moderate level, a 10% rating could also be supported based on functional loss (§4.40). There was no ankylosis of the ankle or subastragalar (sub-tarsal) joints for rating consideration under diagnostic codes 5270 (ankle, ankylosis of) or 5272 (subastragalar or tarsal joint, ankylosis of). After due deliberation, considering all of the evidence, and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the left ankle pain condition (coded 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. As discussed above, PEB reliance on the USAPDA pain policy for rating the chronic left ankle pain was operant in this case and the condition was adjudicated independently of that policy by the Board. In the matter of the chronic left ankle pain condition, the Board unanimously recommends a disability rating of 10%, coded 5271 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
Chronic Left Ankle Pain 5271 10%
RATING 10%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20131023, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record




                 
XXXXXXXXXXXXXXX
President
Physical Disability Board of Review


 SAMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557


 SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXX, AR20150004762 (PD2013002077)
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 10% 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                                                  XXXXXXXXXXXXXXX
                                                      Deputy Assistant Secretary of the Army
                                                      (Review Boards)

CF:
( ) DoD PDBR
( ) DVA

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