RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00441
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050428

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Basic Trainee, medically separated for “right knee pain” with a disability rating of 0%.

CI CONTENTION:  The CI contends his medical separation should be changed to medial retirement.  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 - 20050325	VARD - 20050830	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Pain	5099-5022	0%	History of Tibial Plateau Stress Fracture, Right Leg	5299-5260	NSC	20050805	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:  

Right Knee Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI initially had right knee and shoulder pain during his first enlistment in 1998.  He was on active duty for 1 month before he was given a general discharge.  He had no further problems with his knee until he reinjured it in basic training after subsequent reenlistment.  Radiographic studies from January to March 2005, showed early right tibial plateau stress fractures on a bone scan, normal X-rays, and a knee contusion on magnetic resonance imaging (MRI).  Despite duty restrictions, convalescent leave, and physical therapy, his symptoms persisted and he was unable to return to training.  There was no surgical indication.  He was referred for an MEB.  The MEB forwarded “right knee pain secondary to tibial plateau stress fracture and medial femoral condyle contusion” for PEB adjudication.  

At the MEB NARSUM examination, performed on 4 March 2005, 6 weeks prior to separation, the CI reported pain and swelling in his knee.  On examination, the CI had an antalgic gait; positive effusion (excess fluid); tenderness to palpation; normal sensory and motor function; and full range of motion (ROM).  Painful motion was not specifically documented.  During the VA Compensation and Pension (C&P) evaluation, performed on 5 August 2005, 3 months after separation, the CI reported he experienced a “tightening sensation” with discomfort rated 6/10.  The pain was relieved when the CI “popped” his knee.  The CI did not experience any weakness, instability, giving way or locking sensations.  The CI was a full-time laborer working 50-60 hours a week.  He denied any difficulty with the tasks required of the job from his knee.  On examination, he walked with a normal gait, had no instability, and had normal motor strength.  Knee flexion was full without discomfort.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 0%, coded analogously to 5022 (periostitis), citing full ROM.  The VA did not service connect the right knee condition, citing the medical evidence showed no chronic disability, but analogously coded it to 5260 (leg, limitation of flexion).  There was no evidence of painful motion or limitation of motion to support a 10%.  The examinations proximate to separation did not demonstrate the presence of ligamentous instability or laxity or meniscal symptomatology.  No additional functional limitation was evidenced by the examinations.  Therefore the Board concluded there was not sufficient evidence to support a rating higher than the 0% adjudicated by the PEB.  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 right knee pain condition.

BOARD FINDINGS:  In the matter of the right 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 20150601, with attachments
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

08 Feb 2017

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20170000104 (PD201500441)

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