RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03997
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050608

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

CI CONTENTION:  “Please consider all conditions.”  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 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 – 20050523	VARD - 20060227	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Knee Pain	5259	10%	Degenerative Osteoarthritis and Chondromalacia, Left Knee	5262	10%	20051206	
RATING:  10%	COMBINED RATING:  20%	

ANALYSIS SUMMARY:

Left Knee.  The record shows that the CI was in the Army National Guard from 16 May to 25 August 1994 for training.  At some time in 1994, he had a tear of the left anterior cruciate ligament (ACL) which was repaired by a civilian provider.  These records are not in evidence.  He reinjured the same knee and had a second operation in 1997; again, these records are not in evidence.  He also had a fracture of the right fibula (leg bone next to the shin bone) in 1998.  This history was not disclosed at his enlistment to active duty on the 26 September 2001 accession history and physical.  The CI reinjured his left knee, while deployed.  He then had a left meniscectomy (removal of a cartilage cushion in the knee) in 2004.  Despite extensive rehabilitation, he was not able to return to full duty although his commander noted that he did well in-garrison.  At the MEB narrative summary (NARSUM) examination, dated 24 January 2005, approximately 4 months before separation, the CI reported constant pain which was aggravated by the weather and activity level.  On examination, the knee was stable and signs of meniscal irritation absent.  The range-of-motion (ROM) was normal.  Pressure over the kneecap produced signs consistent with degenerative disease (a not unexpected finding given the history of three operations on the left knee).  Painful motion was not documented.  An X-ray on 16 February 2005 showed changes from the prior ACL reconstruction as well as degenerative changes consistent with arthritis.

At the VA Compensation and Pension (C&P) examination dated 6 December 2005, 6 months after separation, the CI had a normal gait and no functional limitation in standing or walking.  Again, signs of degenerative disease were present, but the knee was stable and the ROM full and pain free.

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the left knee at 10%, coded 5259 (symptomatic removal of a meniscus).  The VA also rated the left knee at 10%, but coded it 5262 (impairment of the tibia and fibula).  The Board considered these codes and others applicable to the knee, but found no route to a rating higher than the 10% adjudicated by both the PEB and VA.  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 chronic left knee pain condition.

BOARD FINDINGS:  In the matter of the chronic left 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 20140915, 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, AR20160005160 (PD201403997)

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