RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	      CASE:  PD-2015-00769
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20060331

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, M1 Armor Crewman, medically separated for “chronic right patellofemoral pain syndrome [PFS]” with a disability rating of 0%.   

CI CONTENTION:  The CI asserts his knees continue to swell and hurt.  He also indicates he has high blood pressure as well as other conditions.  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination is based on 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(s) at the time of separation.  The panel 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 panel 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 - 20060316	VARD – N/A	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right PFS	5099-5003	0%	No VA Exam in Evidence	
Hypertension	Not Unfitting		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS: N/A	

ANALYSIS SUMMARY:  

Chronic Right Patellofemoral Pain Syndrome.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right knee condition began in 2003 after a twisting injury.  Clinic notes in March, April, August, and October 2004 documented tenderness, patellar grinding (consistent with chondromalacia or degenerative joint disease), full range of motion (ROM), and no evidence of instability or meniscal injury.  At an October 2004 physical therapy visit, there was evidence of painful motion.  Radiographic imaging (MRI) in October 2004 reportedly documented a normal knee.  Surgery was not indicated.  

At the 16 November 2005 MEB examination (recorded on DD Form 2808), 4 months prior to separation, the physical examination showed patellar grinding.  At the 14 February 2006 MEB NARSUM, 2 months prior to separation, the CI reported pain aggravated by running, prolonged walking and sitting, carrying any load, and going up stairs.  The physical examination showed patellar grind, with full ROM.  There was no evidence of effusion, tenderness, laxity or meniscal injury.  

There was no VA Compensation and Pension (C&P) evaluation in evidence for review.  

The panel directed attention to the rating recommendation based on the above evidence.  The PEB rated 0% for the right knee condition, coded 5099-5003 (degenerative arthritis), citing full ROM.  

The panel considered the evidence for rating.  There was documentation of right knee pathology (patellar grind) and painful motion in the STR which would warrant a 10% rating IAW VASRD §4.59 (painful motion).  There was no instability, or compensable ROM limitation for higher ratings under knee-specific codes.  Although analogous codes of 5014 (osteomalacia), 5024 (tenosynovitis), or 5257 (knee, other impairment) were considered, none would offer any benefit over coding analogously to 5003 at 10%.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right knee condition.  

Contended PEB Condition:  Hypertension.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was not profiled, implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the right knee condition, the panel unanimously recommends a disability rating of 10%, coded 5299-5003 IAW VASRD §4.71a.  In the matter of the contended hypertension condition, the panel unanimously recommends no change from the PEB determination as not unfitting.  There are no other conditions within the panel’s scope of review for consideration.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160108, w/atchs
Exhibit B.  Service Treatment Record

Dear XXXXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	
Enclosure