RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX.	CASE:  PD-2014-01930
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070816

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Automated Logistics Specialist, medically separated for “left knee pain due to chondromalacia,” with a disability rating of 0%.

CI CONTENTION:  The CI contends for a higher rating for all of his conditions.  The CI’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 based upon a 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 - 20070806	VARD - 20080515	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Knee Pain 	5099-5003	0%	Left Knee	5299-5020	0%	20080128	
Sleep Apnea	Not Unfitting	Sleep Apnea	6847	50%	20080128	
Depressive Disorder, NOS	Not Unfitting 	Major Depressive Disorder/PTSD	9434-9411	10%	20080128	
Anxiety Disorder, NOS	Not Unfitting					
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Left Knee Pain due to Chondromalacia Patella.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left knee pain condition began in October 1998 after blunt trauma. He was seen in Orthopedics in August 2006 with complaints of achiness and instability of the knee.  X-rays were normal. He underwent surgery in December 2006 and was found to have multiple loose bodies and a large defect of his lateral femoral condyle.  Post-operatively he had a full range of motion with no swelling.  Wounds were heeled.  On follow up he reported knee pain with running.  He received a L3 profile.  On May 2007, the MEB forwarded “left knee pain secondary to traumatic arthritis” for PEB adjudication.  

At the MEB examination (recorded on DD Forms 2807 and 2808) dated April 2007, 4 months prior to separation, the CI reported left knee pain since November 2002 but did not know how he hurt himself.  At the MEB NARSUM examination on 30 May 2007, 4 months prior to separation, the CI noted complaints of pain that made him unable to concentrate on his work.  He could not lift or carry materials in a warehouse environment and was unable to go to the range.  He passed his last fitness test.  Physical examination showed no tear in the anterior cruciate ligament (ACL).

At the 28 January 2008 VA Compensation and Pension (C&P) evaluation, performed 5 months after separation, the CI reported pain weekly with walking in the mall for 20 minutes.  He jogged a mile/day and walked his dogs 2 miles/day.  He reported no incapacitating episodes, limitations on standing or walking, muscle weakness, locking, deformity, giving way, dislocation, stiffness or instability.  Physical examination showed no abnormalities of the knee (grinding, instability, deformity, patellar or meniscal abnormalities.   

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the left knee pain condition 0%, coded 5099-5003 (degenerative arthritis) citing the US Army Physical Disability Agency (USAPDA) pain policy.  The VA also rated the condition 0% coded 5299-5020  (synovitis), based on the VA C&P examination 5 months after separation, citing no evidence of painful or limited motion.  The Board noted there was no evidence of painful motion, or limited motion.  X-rays revealed no pathology.  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 left knee pain condition.  

Contended PEB Conditions:  Sleep Apnea, Depressive Disorder NOS, Anxiety Disorder NOS.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  The sleep apnea condition was profiled in May 2007.  The remaining conditions were not profiled or implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions and so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the left knee pain condition and IAW VASRD §4.71a, the Board recommends no change in the PEB adjudication.  In the matter of the contended sleep apnea, depressive disorder NOS, anxiety disorder NOS conditions, the Board recommends no change from the PEB determinations as not unfitting.  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 20140514, 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, AR20160016546 (PD201401930)

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