RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03825
BRANCH OF SERVICE:  Army  	SEPARATION DATE:  20060105

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E5, Trainee, medically separated for “bilateral knee pain,” with a disability rating of 10%.    

CI CONTENTION:  “Please consider all 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 - 20051214	VARD - 20060317   	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Knee Pain	5003	10%	Bilateral Retropatellar Syndrome with Degenerative Joint Disease	5262-5010	10%	20060109	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Bilateral Knee Pain.  The service treatment records (STRs) and the Medical Evaluation Board (MEB) narrative summary (NARSUM) show that the CI was prior US Navy and reported foot and knee problems on her separation physical and history on 3 October 2002.  Review of the STR shows treatment for both.  On the US Army pre-screen dated 9 November 2004, and the accession history dated 11 June 2005, she denied a history of foot or knee problems.  Her foot and knee examinations were unremarkable.  She re-entered active duty on 3 August 2005.  On 6 September 2005 she was seen for a 3-day history of bilateral atraumatic knee pain that began after running and jumping.  She was noted to have tenderness to palpation and to be obese, but the knee examination was otherwise unremarkable.  She was placed in medical hold and given duty restrictions.  Her pain resolved at the time, but recurred when she re-entered training.  She was then entered into the MEB process.  On examination, she had full range of motion (ROM).  Her knees were stable and without signs of meniscal (cartilage cushions in the knees) irritation.  Compression was positive (painful) bilaterally.  Crepitus (an audible or sensible grating sensation with movement) was present bilaterally, but greater on the right.  There was no effusion and painful motion was not documented.  A bone scan was negative, but X-rays had shown mild degenerative joint disease (DJD).  Her prognosis as a civilian was thought to be good.  She was diagnosed with retro-patellar pain syndrome.  At the MEB examination dated 21 November 2005, the CI was noted to have “restricted ROM wt bearing.”  At the VA Compensation and Pension (C&P) examination performed 4 days after separation, the CI reported difficulty with stairs, but otherwise the knees usually did not hurt.  She denied loss of motion, medications, or the use of an assistive device.  The gait was recorded as normal; however, noted a slight limp attributed to right heel pain.  The joints were stable and otherwise unremarkable with normal ROM, pain free motion, and the knees were non-tender.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB and VA both rated the bilateral knee condition at 10%, coded 5003 (degenerative arthritis) and 5262-5010 (impairment of the tibia and fibula - traumatic arthritis), respectively.  The Board considered if the knees were separately unfitting.  This provided no benefit to the CI as neither knee was separately compensable absent limitation in motion, painful motion, or instability.  No criteria to support a higher rating were found in evidence.  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 knee condition.  

BOARD FINDINGS:  In the matter of the bilateral knee pain 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 20140515, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 AR20160013806 (PD201403825)

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