RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03275
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20041004

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an activated National Guard E-4 (Food Service Specialist) medically separated for “persistent left patellar tendonitis pain,” rated at 0%.

CI CONTENTION:  “Please consider all conditions”

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:    

IPEB - Dated 20040720	VA* -  based on Service Treatment Records (STR)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Patellar Tendonitis	5003	0%	Left Patellar Tendonitis	5257	0%	STR	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 0	
RATING:  0%	RATING:  0%	
*Derived from VA Rating Decision (VARD) dated 20030317 (most proximate to date of separation (DOS)).  

ANALYSIS SUMMARY:  

Left Knee Condition.  The CI initially injured her right knee during basic training in 2001.  She completed training and received care from her civilian provider for left patellar tendonitis.  The CI was treated with physical therapy, anti-inflammatory medication, and corticosteroid injections, but continued to report left knee pain.  A magnetic resonance imaging study performed on 3 December 2002 demonstrated thickening of the patellar tendon with mild edema (fluid collection secondary to inflammation).  The CI was diagnosed with an overuse injury.  At the MEB examination, the CI reported 8/10 pain over the left patella.  She denied pain radiation.  The pain was worse with squatting, kneeling, walking, standing greater than 2 hours, and twisting motions.  She used ibuprofen for pain.  The MEB physical examination demonstrated an antalgic gait, “very mild tenderness to palpation over the patella and patellar tendon”, and full active knee range-of-motion.  The CI was able to complete the heel and toe walk, but there was pain noted.  The examiner rendered a diagnosis of persistent left patellar tendonitis.  The CI did not report for a VA examination.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB and VA rated the left knee condition at 0%, coded 5099-5003 (analogous to degenerative arthritis) and 5257 (knee impairment, other), respectively.  The Board considered whether the evidence supported a higher than 0% rating.  Service treatment records evidenced subjective reports of pain with use and objective radiographic and physical examination findings of patellar tendon pathology.  Board members agreed that the evidence supports the application of VASRD §4.40 (functional loss).  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 left knee condition.  

BOARD FINDINGS:  In the matter of the left patellar tendonitis pain condition, the Board unanimously recommends a disability rating of 10%, coded 5099-5003 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 her prior medical separation:  

CONDITION	VASRD CODE	RATING	
Left patellar tendonitis 	5099-5003	10%	
RATING	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140528, 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 XXXXXXXXXXXXXXXXXXXXX, AR20160004506 (PD201403275)

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