RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01008
BRANCH OF SERVICE:  Coast Guard 	SEPARATION DATE:  20051212

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Fireman, medically separated for “patella femoral syndrome analogous to degenerative arthritis,” with a disability rating of 0%.  

CI CONTENTION:  “Condition is still ongoing, making some physical tasks more difficult and painful.”  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 - 20051017	VARD - 20081210	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Patella Femoral Syndrome Analogous to Degenerative Arthritis	5099-5003	0%	Right Knee Patella Femoral Syndrome with Scar	5099-5019	0%	20080728	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Patella Femoral Syndrome (PFS) analogous to Degenerative Arthritis.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right knee pain condition began in January 2004 after riding a stationary bicycle.  She experienced a recurrence of knee pain in early 2005 after physical training.  X-rays were normal and orthopedics diagnosed PFS of the right knee.  There was no surgical indication, and    conservative treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “PFS” for PEB adjudication.  

At the 12 September 2005 MEB NARSUM examination, 3 months prior to separation, the CI endorsed right knee pain resulting in the inability run or stand for an extended amount of time.  Her focal physical examination (PE) was noted as normal except for tenderness about the joint line of the right knee.  There was no evidence of instability.  The VA Compensation and Pension (C&P) examination was conducted nearly 3 years remote of the CI’s date of separation and therefore, the STR and MEB-driven documents were utilized for determining a final impairment rating. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition at 0%, analogously coded 5299-5003 (degenerative arthritis).   The VA rated the right knee condition at 0% analogously coded 5099-5019 (bursitis), citing the absence of painful or limited motion.  There was no evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  Likewise, there was no limitation of motion which attained a minimum rating under the diagnostic codes for limitation of flexion or extension (5260, 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), or history of surgery to remove a meniscus (5259) to support a rating under the respective codes.  Therefore, after due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was not sufficient evidence to support a rating higher than the 0% adjudicated by the PEB.

BOARD FINDINGS:  In the matter of the right knee condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150609, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

XXXXXXXXXXXXXXXXXXXXX
Dear XXXXXXXXXXXXXXXXXXXXX,
I am the Designated Decision Authority for the Coast Guard on applications submitted to the Department of Defense Physical Disability Board of Review (PDBR).  Under the authority of Title 10, United States Code, section 1554a, I accept the PDBR’s recommendation in your case (Case Number PD-2015-01008) and decline to modify your findings. 

Enclosed for your information are a copy of the PDBR’s recommendation and a copy of the record of proceedings. 

A copy of this decision has also been provided to Coast Guard Enlisted Personnel Management Branch, the PDBR, and the Department of Veterans Affairs. 

If you have any further questions, please contact the Coast Guard Personnel Service Center at XXXXXXXXXXXXXXXXXXXXX. 
	Sincerely,
	XXXXXXXXXXXXXXXXXXXXX
Assistant Commandant for Human Resources	

2 Enclosures		
	
Copy:	CG Personnel Service Center (EPM-1)
DoD Physical Disability Board of Review
Department of Veterans Affairs