RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00776
BRANCH OF SERVICE:  marine corps	SEPARATION DATE:  20050815

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Aviation Ordnance Systems Technician, medically separated for “left knee post-traumatic arthritis to medial compartment,” with a disability rating of 10%.

CI CONTENTION:  The CI’s knee condition continues to worsen and negatively impacts daily activities.  Additionally, the CI contends review of several conditions not identified by the MEB or PEB.  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 – 20050505	VARD - 20140204	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Knee Post-Traumatic Arthritis	5099-5003	10%	Left Knee Meniscal/Medial Cruciate Ligament Injury	5260	10%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Left Knee.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left knee condition began in April 2004 while playing softball and the CI reinjured his knee in July 2004 while carrying a heavy load.  On 15 July 2004 he underwent arthroscopic surgery to debride a medial meniscus tear.  The MEB forwarded meniscal tear for PEB adjudication.  The orthopedics examination on 02 July 2004, 14 months prior to separation, noted complaints of left medial knee pain.  Physical examination showed an antalgic gait, tenderness with range of motion (ROM) of flexion 120 degrees (normal 140) and extension 3 (normal 0); painful motion was not addressed; however, lidocaine was injected prior to the reported examination.  The physical therapy examination on 13 August 2004, 12 months prior to separation, noted complaints of left knee pain more in the morning than the afternoon and difficulty with walking and standing.  Physical examination showed an antalgic gait, tenderness, painful patella grind, and flexion of 115 degrees and extension 5; painful motion was not addressed.  The MEB NARSUM examination on 12 January 2005, 7 months prior to separation, noted complaints of left medial knee pain with sitting, squatting and load bearing.  Physical examination showed knee tenderness, effusion with full ROM; painful motion was not addressed.  At the MEB examination dated 26 January 2005, 7 months prior to separation, the CI reported left knee pain with an inability to run or walk long distances due to pain.  Physical examination showed an antalgic gait, positive McMurray test (abnormal meniscus) with ROM showing full flexion and extension limited to 5-10 degrees; painful motion was not addressed.  The VA did not perform a Compensation and Pension examination, but did review the CI’s STR which led to vocational rehabilitation in 2014, more than 8 years after separation.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left knee condition 10%, analogously coded 5099-5003 (degenerative arthritis).  The VA granted vocational rehabilitation for the left knee condition, coded 5260 (leg, limitation of flexion), based on the CI’s STR.  Board members agreed there was no limitation of flexion or extension that supported a 20% rating under the VASRD diagnostic codes for limitation of motion (5260 or 5261).  The examinations proximate to separation did not demonstrate the presence of ligamentous instability or laxity (5257), and there was no history of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258) to support a rating under the respective codes.  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).  No additional functional limitation was evidenced by the examinations.  There is therefore no VASRD §4.71a route to a rating higher than the 10% adjudicated by the PEB under any applicable code, and no grounds for additional rating based on the presence of instability.  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 left knee condition.  

BOARD FINDINGS:  In the matter of the left knee post-traumatic arthritis 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 20150611, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 15 Nov 16

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC

						  XXXXXXXXXXXXXXXXXXX
	     				  Assistant General Counsel
						  (Manpower & Reserve Affairs)