Search Decisions

Decision Text

AF | PDBR | CY2014 | PD-2014-02460
Original file (PD-2014-02460.rtf) Auto-classification: Approved
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX    CASE: PD-2014-02460
BRANCH OF SERVICE: Army  BOARD DATE: 20150128
SEPARATION DATE: 20031120


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-5 (Light Wheeled Mechanic) medically separated for a right ankle condition. The right ankle condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty or satisfy physical fitness standards but was authorized to perform an alternate aerobic event to satisfy physical fitness standards. He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). “Right ankle pain” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other condition was submitted by the MEB. The Informal PEB adjudicated “chronic right ankle pain” as unfitting, rated 0% with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). The CI made no appeals and was medically separated.


CI CONTENTION: “Please consider all conditions.”


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 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 :

IPEB – Dated 20030909
 VA* - (~7 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Chronic Right Ankle Pain 5099-5003 0% Degenerative Joint Disease, Right Ankle 5271-5010 10% 20040618
Other x 0 (Not In Scope)
 Other x 11
RATING: 0%
 RATING: 10%
* Derived from VA Rating Decision (VA RD ) dated 20 050208 (most proximate to date of separation ( DOS ) ) .





ANALYSIS SUMMARY:

Right Ankle Condition. The CI described hearing a “pop” in his right ankle accompanied with pain while running as part of physical training in June 2001. Radiologic work-up noted joint fluid about the heel with surrounding tendonitis. Despite mainstay treatment of physical therapy, immobilization, pain medication, and activity restrictions, his painful symptoms remained. He was permanently profiled in October 2002 and underwent an MEB. At the MEB narrative summary examination (performed 4 months prior to separation), the CI reported right ankle pain with weight-bearing or upon ambulation. The MEB physical examination (PE) noted decrease range-of-motion (ROM) and tenderness on the outside of the right ankle. Guarding (involuntary muscle contractions due to pain) was present upon side-to-side ankle motion. There was no evidence of instability. The examiner stated, “The [CI] currently has difficulty ambulating, secondary to ankle pain.” At the VA Compensation and Pension examination (performed 7 months after separation), the CI reported right ankle pain associated with weakness, stiffness, occasional swelling and lack of endurance. His PE revealed near normal, but painful motion of the right ankle. There was no joint instability. All motor and sensory parameters were normal.

The ROM evaluations in evidence which the Board weighed in arriving at its rating recommendation, with documentation of additional ratable criteria, are summarized in the chart below.

Right Ankle ROM
(Degrees)
MEB ~ 4 Mo. Pre-Sep

V A C&P ~7 Mo. Post-Sep
Dorsiflexion (20 Normal) 10 20
Plantar Flexion (45) 30 20
Comment (+) guarding painful motion
§4.71a Rating 10% 10 %
invalid font number 31502
The Board directed attention to its rating recommendation based on the above evidence. The PEB’s 0% rating analogous to 5003 (degenerative arthritis) cited “No significant loss of ROM or evidence of joint instability.” The VA’s 10% rating was under the primary code 5271 (ankle limitation of motion) for “moderate” limitation. Board members first agreed with the VA’s primary code of 5271. Both the MEB’s ROM and the VA’s ROM equate to a “moderate” loss of motion, appropriately rated 10%. Board members also agreed that sufficient evidence of painful motion (expressed either directly or through muscular guarding) was present to support a rating of 10% IAW VASRD §4.59. Lastly, the Board considered the unilateral code 5284 (other foot injuries) and agreed that the maximum impairment in this case would rate no greater than “moderate”; again, yielding the same impairment of 10%. In the absence of ankylosis (frozen joint) or astragalectomy (surgical removal of the talus), there are no other available alternate ankle joint codes available. The only route to a higher rating would be 20% under 5271 for “marked” limitation of motion. The Board agreed that the preponderance of the ROM evidence was more reasonably characterized as “moderate” in support of a 10% rating. 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 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, 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:

CONDITION VASRD CODE RATING
Chronic Right Ankle Pain 5271 10%
RATING 10%


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20140519, 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, AR20150010617 (PD201402460)


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 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

Similar Decisions

  • AF | PDBR | CY2013 | PD-2013-02566

    Original file (PD-2013-02566.rtf) Auto-classification: Approved

    The requested back condition, which was determined to be not unfitting by the PEB, is likewise addressed below.The Board acknowledges the CI’s information regarding the significant impairment with which her serviceconnected condition continues to burden her; but must emphasize that the Disability Evaluation System has neither the role nor the authority to compensate members for anticipated future severity or potential complications of conditions resulting in medical separation. At the MEB...

  • AF | PDBR | CY2012 | PD 2012 00577

    Original file (PD 2012 00577.rtf) Auto-classification: Denied

    The other conditions forwarded by the MEB and adjudicated as not unfitting by the PEB were left ankle instability s/p modified Brostrom procedure, left ankle Achilles tendonitis s/p Achilles tendon debridement, recurrent and chronic left ankle synovitis, and chronic left ankle pain. Left Achilles Tendonitis s/p Debridement;Left Ankle Synovitis;Chronic Left Ankle Pain .None of these conditions were separately profiled while on LIMDU, implicated in the commander’s assessment, or noted as...

  • AF | PDBR | CY2014 | PD 2014 00304

    Original file (PD 2014 00304.rtf) Auto-classification: Approved

    The commander’s statement to the PEB (2 months prior to the CI’s separation),noted that the MEB would evaluate the CI’s ability to perform his duty based on limitations imposed by his permanent physicalprofile for bilateral ankle instability. The left knee condition was Providing a correction to the individual’s separation document showing that the individual was separated by reason of permanent disability retirement effective the date of the original medical separation for disability with...

  • AF | PDBR | CY2013 | PD-2013-01529

    Original file (PD-2013-01529.rtf) Auto-classification: Approved

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of theVeterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. On 25 June 2004 a formal goniometric range-of-motion (ROM) testing from physical therapy was referenced in the NARSUM and documented active ROM of 0 degrees dorsiflexion (normal 20 degrees) and 30 degrees plantar...

  • AF | PDBR | CY2014 | PD-2014-01873

    Original file (PD-2014-01873.rtf) Auto-classification: Denied

    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. RATING COMPARISON : Service FPEB – Dated 20071127VA* - Based on Service Treatment Records(STR)ConditionCodeRatingConditionCodeRatingExam Chronic Pain Left Foot, Possibly Secondary to Sural Neuralgia8799-872510%Left Ankle Condition, Status Post Brostrom Surgery52710%STRSural...

  • AF | PDBR | CY2014 | PD-2014-01364

    Original file (PD-2014-01364.rtf) Auto-classification: Approved

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of theVeterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. Right Ankle Condition . At the MEB examination on 23 November 2005, 4 months prior to separation, the CI reported constant right ankle pain worsened by weight bearing activities or twisting of the ankle treated with...

  • 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-2013-02659

    Original file (PD-2013-02659.rtf) Auto-classification: Denied

    She was placed on limited duty twice and referred for a Medical Evaluation Board (MEB). The rating for the unfitting ankle condition is addressed below; no additional conditions are within the DoDI 6040.44 defined purview of the Board. The Board concluded therefore that this condition could not be recommended for additional disability rating.

  • AF | PDBR | CY2012 | PD2012-00316

    Original file (PD2012-00316.pdf) Auto-classification: Approved

    The MEB forwarded chronic right ankle pain to the Physical Evaluation Board (PEB). Sub-talar motion 20 degrees 10% N/A 10% §4.71a Rating N/A At the MEB exam performed on 1 November 2005, the CI reported pain and swelling of the right ankle. The VA coded the ankle 5271 and rated it 10% for moderate limitations in ROM.

  • 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...