RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04003
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20041007

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E-2, Multichannel Transmission Systems Operator-Maintainer, medically separated by the Informal Physical Evaluation Board (IPEB) for right knee pain, with a disability rating of 10%.

CI CONTENTION:  “I had three knee surgeries due to the dislocation of my (rt) knee!  I still have pain everyday due to my injury.”  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 – 20040915	VARD - 20041222 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Injury	5257	10%	S/P R Knee Dislocation with Closed Reduction and ACL Tear	5261	10%	20041109	
RATING:  10%	COMBINED RATING:  10%	

ANALYSIS SUMMARY:

Right Knee Injury.  The record shows that the CI rotated and twisted his right knee on 4 September 2003 during pugil stick training in the third week of basic training.  The knee dislocation was reduced under anesthesia that day.  A magnetic resonance imaging (MRI) scan 2 weeks later showed a bone contusion of the knee and a tear of the fibrous tissue on the side of the knee (inside or medial), but an intact ACL and menisci (cartilage cushions inside the knee).  He was treated with duty limitations, medications, and physical therapy with improvement in his symptoms.  However, he again twisted his knee on 26 January 2004.  On 24 February 2004 he had operative debridement of scar tissue within the knee.  The ACL was found to be damaged.  Due to this and subjective instability, the ACL was repaired on 31 March 2004.  He continued rehabilitation, but was not able to return to full duty and an MEB was initiated.  An orthopedic examination on 23 July 2004, just over 3 months after the final surgery, noted a 1+ Lachman, but an otherwise stable knee with nearly full range-of-motion (ROM).  The narrative summary (NARSUM) was dated 5 August 2004, 2 months prior to separation.  The CI reported knee pain with any type of activity.  The knee was well healed.  Both a Lachman and anterior drawer were 1+, but with a solid end point (slightly loose, but stable).  A slight effusion was present.  The ROM was unchanged from the orthopedic examination.  Both of these ROM exams are charted below.  The VA Compensation and Pension (C&P) examination was performed on 9 November 2004, 1 month after separation.  He reported pain with activity.  On examination, the posture, gait, and ROM were normal.  Crepitus, a sign of degenerative change, was present on the right.  The knee was stable to examination.  
The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the knee at 10%, coded 5257 (other impairment of the knee).  The VA also rated the knee at 10%, but coded it 5261 (limitation of extension).  The Board considered these codes and others appropriate for the knee condition, but found no route to a rating higher than the 10% adjudicated by both the PEB and VA.  After due deliberation, and in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the right knee condition.

BOARD FINDINGS:  In the matter of the right knee injury with dislocation and ACL tear, 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 20140916, 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, AR20160005167 (PD201404003)

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