RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE:  PD-2014-00339
BRANCH OF SERVICE:  Army		 SEPARATION DATE:  20040510

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E-4, Human Resource Management Specialist, medically separated by the Informal Physical Evaluation Board (PEB) for “right knee pain” with a disability rating of 10%.

CI CONTENTION:  The CI feels that he should have been rated for both knees and his high blood pressure.  The applicant’s complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  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 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:

SERVICE PEB - 20040123	VARD – 20050908	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Pain	5003	0%	Right Knee Degenerative Joint Disease	5003	10%	20050616	
COMBINED RATING:  0%	COMBINED RATING FOR ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Right Knee Pain.  Over a 3-year period the CI had multiple injuries to his right knee and underwent two arthroscopic surgeries which revealed significant degenerative changes as well as a build-up of scar tissue.  Postoperatively, his painful symptoms initially improved but returned with activity and prolonged standing.  He was permanently profiled in August 2001 and was referred to a Medical Evaluation Board (MEB).  At the narrative summary (NARSUM) examination dated 15 December 2003 (5 months prior to separation) the CI endorsed right knee pain with any bending, squatting, kneeling or standing for prolonged periods.  His physical examination revealed a stable, normal right knee with nearly full but painful motion.  Flexion was measured at 130 degrees (normal 140 degrees).  The DD Form 2808 dated 02 December 2003 also noted similar physical findings.  His diagnosis remained as right knee pain.
At the VA Compensation & Pension (C&P) examination performed on 16 June 2005 (13 months after separation) the CI endorsed persistent right knee pain aggravated by maneuvering stairs.  He denied the occurrence of dislocations and or subluxations.  The physical exam revealed joint line tenderness, kneecap tenderness, crepitus, painful motion,and decreased flexion to 110 degrees.  There was no knee instability noted.  The VA diagnosis was listed as status post injury of right knee with several repairs, with development of degenerative joint disease.

The Board directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA coded the right knee condition under 5003 (degenerative arthritis) and rated 0% and 10%, respectively.  All Board members agreed that the NARSUM examination be apportioned exclusive probative value in determining an impairment rating due to its close time reference to the date of separation.  Although non-compensable ROM was present, the MEB examination clearly indicated painful motion (VASRD §4.59) supporting a maximum 10% rating.  Absent effusion, meniscal removal, or instability, there is no route to an impairment rating higher than 10% under any other applicable knee codes.  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 knee condition.

BOARD FINDINGS:  In the matter of the right knee condition, the Board unanimously recommends a disability rating of 10%, coded 5003 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  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	
Right Knee Pain	5003	10%	
RATING	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20131218, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 XXXXXXXXXXXXXXXXXX, AR20160005437 (PD201400339)

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, accept the Board’s recommendation to modify the individual’s disability rating to 10% without re-characterization 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:

CF: 
(  ) DoD PDBR
(  ) DVA