Search Decisions

Decision Text

AF | PDBR | CY2014 | PD-2014-00003
Original file (PD-2014-00003.rtf) Auto-classification: Approved
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX    CASE: PD-2014-00003
BRANCH OF SERVICE: Army  BOARD DATE: 20150212
SEPARATION DATE: 20051220


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-6 (Automated Logistics Specialist) medically separated for bilateral ankle condition. These conditions could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty. He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). Degenerative joint disease (DJD) bilateral ankles with chronic painful ankles, characterized as “falling below retention standards,” were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. The MEB also identified and forwarded three other conditions. The Informal PEB adjudicated chronic bilateral ankle pain as unfitting, rated 10%, with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). The remaining conditions were determined to be not unfitting. The CI made no appeals and was medically separated.


CI CONTENTION: “At the time my right and left foot and ankle were diagnose as just bilateral ankles. Instead it should have been my R/L foot and ankles were all degenerative arthritis joint disease. The severity of all injuries was worse than perceived. Arthritis was in both feet and ankles and worse than thought.”


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 when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting. Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records. Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate. The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions. That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws. The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.



RATING COMPARISON :

Service IPEB – Dated 20051014
 VA* - (~2.5 to 3 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Chronic Bilateral Ankle Pain 5010 10% Right Ankle DJD 5010-5284 10% 20060317
20060306
Left Ankle DJD 5010-5284 10% 20060317
20060306
Other x 3 (Not in Scope)
 Other x 10
Combined: 10%
 Combined: 70%
*Derived from VA Rating Decision (VARD) dated 200 60420 (most proxima te to date of separation (DOS))


ANALYSIS SUMMARY:

Chronic Bilateral Ankle Pain. According to service treatment records and the MEB narrative summary the CI developed degenerative arthritis of both ankles associated with recurrent ankle injuries and two surgeries on the right ankle in November 1997 and May 2000. X-rays in March 2005 and April 2005 demonstrated degenerative arthritis of both ankle joints. At the time of the MEB examinations in August 2005, the CI reported bilateral ankle pain, right more than left with prolonged standing and walking or running. At the MEB examination on 3 August 2005 (DD Form 2808), dorsiflexion of both ankles was 0 degrees (normal 20 degrees) and plantar flexion was 35 degrees (normal 45 degrees). At the orthopedic MEB examination on 29 August 2005, dorsiflexion of both ankles was 0 degrees. Plantar flexion of the right ankle was 20 degrees and 30 degrees in the left ankle. Three was no joint instability. There was a limping gait favoring the right ankle. The VA Compensation and Pension (C&P) examination from March 2006, 3 months after separation, was not available in the file; however, the VARD on 20 April 2006, recorded the results of the C&P examination. According to the VARD the CI reported bilateral ankle pain with use. The range-of-motion of both ankles was normal, and there was no swelling. However, there was a limping gait and X-rays demonstrated degenerative arthritis.

The Board directed attention to its rating recommendation based on the above evidence. The PEB rated the chronic bilateral ankle pain secondary to degenerative arthritis 10%, coded 5010 (arthritis due to trauma) citing ankle pain as the reason for unfitness (not limitation of motion). VASRD diagnostic code 5010 is rated under code 5003 (degenerative arthritis) which provides for a single 10% rating for two or more major joints when there is not limitation of motion which supports a separate rating. Although the VA C&P examination was reported to show no limitation of motion, the Board considered the limitation of motion at the MEB examinations to approximate a moderate limitation of motion. While the PEB cited the limitation of motion as not the unfitting feature of the bilateral ankle condition, the Board concluded there was sufficient evidence of functional loss (§4.40) for each ankle to support a 10% rating for each ankle. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt) and §4.40 (functional loss), the Board recommends a separate 10% disability ratings for the right and left ankle post-traumatic DJD (5010).


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. In the matter of the chronic bilateral ankle pain secondary to degenerative arthritis, the Board unanimously recommends a separate disability ratings of 10% for the right and left ankle coded 5010 IAW VASRD §4.71a for a combined rating of 20% (with application of the bilateral factor). 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
Right Ankle Pain Secondary To Degenerative Arthritis 5010 10%
Left Ankle Pain Secondary To Degenerative Arthritis 5010 10%
COMBINED (w/ BLF) 20%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20131217, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record




XXXXXXXXXXXXXXX
President
DoD 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, AR20150011025 (PD201400003)


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              XXXXXXXXXXXXXXX
                  Deputy Assistant Secretary of the Army
                  (Review Boards)

CF:
( ) DoD PDBR
( ) DVA

Similar Decisions

  • AF | PDBR | CY2013 | PD-2013-01822

    Original file (PD-2013-01822.rtf) Auto-classification: Approved

    Bilateral knee degenerative joint disease (DJD), left greater than right and left ankle pain were forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. Post-Separation) ConditionCodeRatingConditionCodeRatingExam Degenerative Arthritis of the Knees500310%Degenerative Joint Disease, R Knee5010-526010%20040925Degenerative Joint Disease, L Knee5010-526010%20040925Left Ankle PainNot UnfittingLeft Ankle Sprain5299-52700%20040925Other x 0 (Not in Scope)Other x 6 Rating: 10%Combined:...

  • AF | PDBR | CY2013 | PD-2013-01542

    Original file (PD-2013-01542.rtf) Auto-classification: Denied

    There was extremely limited service treatment record (STR)in evidence related to the low back pain condition for the Board to consider for rating recommendation. Bilateral Hip Pain .The PEB combined the bilateral hip pain conditions under a single disability rating analogously coded, 5003. As noted above, the Board,IAW VASRD §4.7 (higher of two evaluations), must consider separate ratings for PEB bilateral joint adjudications; although, separate fitness assessments must justify each...

  • AF | PDBR | CY2011 | PD2011-00826

    Original file (PD2011-00826.docx) Auto-classification: Approved

    Bilateral Ankles . The VA initially rated the C&P exam at 10% for each ankle using 5010-5271 (specifying ankle limitation of motion), with increase on appeal to 20% each side based on the same exam and VA treatment records through 26 May 2006 (approximately 17 months post-separation). In the matter of the bilateral ankle condition the Board unanimously recommends that it be rated for two separate unfitting conditions as follows: left ankle coded 5010-5271 and rated 10% and right ankle...

  • AF | PDBR | CY2012 | PD 2012 00887

    Original file (PD 2012 00887.txt) Auto-classification: Approved

    Post-Separation) – All Effective Date 20060409 Condition Code Rating Condition Code Rating Exam Chronic LBP 5299-5242 0% DDD Lumbosacral Spine 5243 40% 20070122 Chronic Bilateral Knee Pain 5099-5003 0% S/P Arthroscopic Repair of Medial Meniscal Tear Right Knee w/ Traumatic DJD 5260-5010 10% 20070124 Left Knee Injury 5260 NSC* 20070122 No Additional MEB/PEB Entries Other x 13 20070122 Combined: 0% Combined: 70% Derived from VA Rating Decision 20070308 (most proximate from the date of...

  • AF | PDBR | CY2013 | PD-2013-00025

    Original file (PD-2013-00025.rtf) Auto-classification: Denied

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. The PEB requested a psychiatric evaluation due to reference in the MEB and medical records of anxiety disorder NOS and PTSD.The NARSUM psychiatric addendum dated 19 July 2001 notedthe CI’s episodic anxiety was due to...

  • AF | PDBR | CY2014 | PD-2014-00517

    Original file (PD-2014-00517.rtf) Auto-classification: Approved

    invalid font number 31502 IPEB – Dated 20060915VA* - (~4 days Pre-Separation) ConditionCodeRatingConditionCodeRatingExam Chronic Left Ankle Pain…5099-50030%S/P Left Ankle Arthroscopy Debridement…5271-501010%20061012Scar, S/P Left Ankle Arthroscopy Debridement…780410%20061012Other MEB/PEB Conditions x 0 (Not In Scope)Other x 8 RATING: 0%COMBINED RATING: 50% *Derived from VA Rating Decision (VARD) dated 20061108 (most proximate to date of separation (DOS)). Left Ankle Condition . The VA...

  • AF | PDBR | CY2012 | PD 2012 00450

    Original file (PD 2012 00450.txt) Auto-classification: Approved

    RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW NAME: XXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY CASE NUMBER: PD1200450 SEPARATION DATE: 20080531 BOARD DATE: 20130208 SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SSG/E-6 (63D30 / Field Artillery Mechanic), medically separated for “bilateral knee and left hip pain from conditions that occurred before entering the Army (EPTS [Existed Prior to...

  • AF | PDBR | CY2012 | PD2012-00042

    Original file (PD2012-00042.docx) Auto-classification: Approved

    Additionally, the MEB measurements are consistent with corroborating evidence; the MEB measurements are consistent with the diagnostic and clinical pathology in evidence; there is not a reasonable accounting for progressively impaired ROM in the fairly short interval between the MEB and VA examinations; therefore, based on all evidence and associated conclusions just elaborated, the Board is assigning preponderant probative value to the MEB evaluation. In accordance with VASRD code 5003...

  • AF | PDBR | CY2013 | PD 2013 00518

    Original file (PD 2013 00518.rtf) Auto-classification: Denied

    The CI had a long history of chronic right knee pain and arthritis dating from 1992. The PEB coded the DDD right knee condition as 5003 arthritis, degenerative (hypertrophic or osteoarthritis) and rated at 10%.The VA coded the right knee s/posteotomy proximal tibial plateau, with DJD condition and rated at 5010 arthritis, due to trauma, substantiated by X-ray findings with 5262tibia and fibula, impairment of and rated at 20%, with moderate knee disability, citing, “ This 20percent is...

  • AF | PDBR | CY2012 | PD2012 01855

    Original file (PD2012 01855.rtf) Auto-classification: Denied

    No other conditions were submitted by the MEB.The PEB adjudicated “chronic bilateral knee pain, rated as slight/constant”as unfitting and rated 10% in accordance with theUS Army Physical Disability Agency (USAPDA) pain policy.The CI made no appeals and was medically separateda10% disability rating. 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...