RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	     CASE:  PD-2014-01473
BRANCH OF SERVICE:  Army	separation DATE:  20090427

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E-4, Motor Transport Operator, medically separated for “bilateral patellar-femoral syndrome with bilateral knee pain” with a disability rating of 20%.

CI CONTENTION:  The applicant “total hearing loss of the left ear” in his application.  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 Physical Evaluation Board (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 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 PEB - 20090210	VARD - 20090720	
Condition	Code	Rating	Condition	Code	Rating	Exam	
… Bilateral Knee Pain	5099-5003	20%	Patellofemoral Syndrome, Right Knee	5261	10%	20090420	
			Patellofemoral Syndrome, Left Knee	5261	10%		
COMBINED RATING:  20%	COMBINED RATING FOR ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Bilateral Knee Pain.  The first record in evidence for the bilateral knee pain was dated 6 March 2008.  The CI was treated with medications, but his pain persisted.  X-rays on 15 July 2008 of each knee were normal.  Over the course of the next year, he was treated with medications, physical therapy (PT), and duty restrictions, but his pain persisted.  At an orthopedic evaluation on 8 December 2008, he was noted to be unable to meet duty requirements and referred for Medical Evaluation Board (MEB).  The narrative summary was dated 12 January 2009.  The CI reported ongoing bilateral knee pain which developed without antecedent trauma.  On examination, the range-of-motion (ROM) was limited and painful as charted below.  The kneecaps were tender, but the examination of the knees was otherwise unremarkable.  At the MEB examination on 12 January 2009, the knees were stable and without tenderness or swelling.  

The VA Compensation and Pension (C&P) examination was performed on 20 April 2009, 7 days before separation.  The CI reported gradual and progressive bilateral knee pain.  His posture and gait were normal.  The ROM was limited and painful, but there was not further change with repetition.  His kneecaps were tender, but the examination was otherwise unremarkable.  

The PEB and VA both rated each knee at 10% for painful motion, coded 5099-5003 (analogous to degenerative arthritis) and 5261 (limitation in extension), respectively.  The Board found no route to a higher rating using these or other codes applicable to the knees.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the bilateral patello-femoral syndrome condition.  

BOARD FINDINGS:  In the matter of the bilateral patello-femoral syndrome 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.  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 20140325, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB

28 JUL 2016

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 XXXXXXXXXXXXXXXXXXXX, AR20160006072 (PD201401473)

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 and hereby deny the individual's application.
This decision is final. The individual concerned, counsel (if any), and any Members of
Congress who have shown interest in this application have been notified of this decision
by mail.

BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure

CF:
( ) DoD PDBR
( ) DVA