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AF | PDBR | CY2013 | PD-2013-02287
Original file (PD-2013-02287.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXX     CASE: PD-2013-02287
BRANCH OF SERVICE: MARINE CORPS  BOARD DATE: 20140627
SEPARATION DATE: 20060201


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (1171/Hygiene Equipment Operator) medically separated for left ankle arthritis. The ankle condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty or satisfy physical fitness standards. He was placed on limited duty and underwent a Medical Evaluation Board (MEB). The ankle condition, characterized as “posttraumatic arthritis of the left ankle” was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E. The MEB forwarded no other conditions to the PEB. The PEB adjudicated “post-traumatic arthritis of the left ankle” as unfitting, rated 20%, with likely application of VA Schedule for Rating Disabilities (VASRD). The CI made no appeals and was medically separated.


CI CONTENTION: “Broken left ankle; arthritis in left ankle; hardware in left ankle”


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 left ankle condition is addressed below. No other conditions are within the DoDI 6040.44 defined purview of the Board. Any conditions outside the Board’s scope of review may be eligible for consideration by the Board for Correction of Naval Records.


 RATING COMPARISON :

Navy PEB – dated 20050921
 VA – (14 mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Left Ankle Arthritis 5299-5262 20% Left Ankle Condition 5010-5271 10% 20070409
Other x 0 (Not in Scope)
 Other x 0
Rated: 20%
 Rated: 10%
Derived from VA Rating Decision (VA RD ) dated 200 70513 ( most proximate to date of separation [ DOS ] )


ANALYSIS SUMMARY:

Left Ankle Condition. In June 2003, this CI fractured his left ankle. He underwent open reduction/internal fixation (ORIF). After surgery the fracture healed, but he developed post-traumatic arthritis of the left ankle. Due to his limited range-of-motion (ROM) and persistent ankle pain, a MEB was initiated. The MEB narrative summary was dictated by an orthopedist at US Naval Hospital Rota, Spain. At that time, the CI walked with a slightly stiff gait, favoring the left ankle. Physical examination (PE) of the left ankle revealed minimal tenderness to palpation (TTP). Surgical incisions were well healed. There was no swelling and no skin changes consistent with infection. The left lower extremity was neurovascularly intact, with good pulses. Ankle ROM was measured and is shown in the chart below.
The CI was separated from service on 1 February 2006. Fourteen months later, he had a VA Compensation and Pension exam. Posture and gait were normal. PE of the left ankle revealed no edema (swelling), effusion, weakness, TTP, redness, heat, abnormal movement, guarding or deformity. ROM was measured and is summarized in the chart below.


Left Ankle ROM
(Degrees)
Ortho ~ 8½ mos. Pre-Sep
 		NARSUM (no date)
VA C&P ~ 14 mos . Post-Sep
Dorsiflexion (20 Normal) 0 0 0
Plantar Flexion (45) 45 45 45
§4.71a Rating 10%-20% 10%-20 % 10%-20 %
invalid font number 31502
The Board directs attention to its rating recommendation based on the above evidence. The Navy PEB and the VA chose different coding and rating options for the left ankle condition. The PEB coded it 5299-5262 (analogous to malunion) and assigned a rating of 20%, for moderate ankle disability. The VA chose diagnostic code 5010-5271 (post-traumatic arthritis, with limitation of ankle motion), and rated it 10% (moderate). After due deliberation, the Board determined that a rating of 20% was appropriate, due to moderate ankle disability. The Board tried to find a path to a rating higher than 20%, using other codes which could be applied to the ankle condition. The other VASRD codes that were considered did not result in a higher rating. The record did not show evidence of a significantly disabling ankle abnormality which would justify a higher rating. Considering all of the evidence and mindful of VASRD §4.3 (resolution of reasonable doubt) and §4.7 (higher of two evaluations), the Board found 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 that there be no re-characterization of the CI’s disability and separation determination.
The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20131105, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record






                 
XXXXXXXXXXXXXX
President
Physical Disability Board of Review

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 12 Feb 15

In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, 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:
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC


                                                      XXXXXXXXXXXXXXX
                                            Assistant General Counsel
                                                      (Manpower & Reserve Affairs)

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