RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE:  PD-2014-04083
BRANCH OF SERVICE:  army		SEPARATION DATE:  20080102

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Signal Support System Specialist, medically separated for “tendonitis of the left patella” with a disability rating of 0%.

CI CONTENTION:  “Can’t bare all of my weight on left knee.  VA findings gave a larger percentage.”  His 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 - Dated 20080102	VARD - 20080104	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Patella Tendonitis	5024	0%	Status Post Left Knee Surgery with Scar	5260-5010	10%	20071016	
COMBINED RATING:  0%	COMBINED RATING FOR ALL VA CONDITIONS:  70%	

ANALYSIS SUMMARY:

Left Knee.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI injured his left knee during physical training in September 2004.  Radiographic imagining revealed no significant bone or soft tissue abnormalities.  On 12 October 2006, 15 months before separation, the CI underwent surgical debridement of the left knee.  Despite pain relief medications and physical therapy (PT) the left knee condition could not be adequately rehabilitated to meet the physical requirements of his military occupational specialty (MOS).  He was issued a permanent L3 profile and was referred for a MEB.  The MEB forwarded “left patella tendonitis” and “Osgood-Schlatter disease” for PEB adjudication.

According to the MEB NARSUM in September 2007, 4 months before separation, the CI reported left knee pain.  The physical examination (PE) revealed tenderness about the left knee.  There was no instability.  The MEB NARSUM referenced a PT examination conducted in August 2004, also 4 months before separation, that noted painful range of motion (ROM) as flexion 130 degrees (140 normal) and extension 0 (0 normal).

At the VA Compensation and Pension (C&P) examination in October 2007, 3 months before separation, the CI reported constant left knee pain and give way with weight-bearing, weakness, lack of endurance with prolonged walking, and locking with prolonged standing.  The examination revealed painful and slight decrease in ROM; flexion was 130 and extension was normal.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the condition 0% coded 5024 (tenosynovitis) with application of the US Army Physical Disability Agency Pain Policy.  The VA rated the condition 10% analogously coded 5260-5010 (limitation of flexion-traumatic arthritis) based upon the C&P examination, citing painful or limited motion of a major joint or group of minor joints.  Board members agreed there was no limitation of flexion or extension that supported a minimum rating under the VASRD diagnostic codes for limitation of motion (5260 or 5261).  However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There was no evidence of subluxation or lateral instability to support a separate 10% rating under the 5257 code (knee, other impairment).  There was no fracture, non-union, or malunion of the femur or tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262).  After due deliberation, and in consideration of all the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the left knee pain condition coded 5024.

BOARD FINDINGS:  In the matter of the left patella tendonitis condition, the Board unanimously recommends a disability rating of 10%, coded 5024 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  The Board therefore recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:

CONDITION	VASRD CODE	RATING	
Left Patella Tendonitis	5024	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 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 AR20160011803 (PD201404083)

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