RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01720
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20080904

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Unit Supply Specialist, medically separated for “right knee pain with patellofemoral syndrome,” with a disability rating of 10%.

CI CONTENTION:  “There was a miscommunication about appointment rescheduling.”  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 - 20080522	VARD – 20120413	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Pain…	5099-5003	10%	Right Knee Patellofemoral Syndrome	5260	NSC	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NSC	

ANALYSIS SUMMARY:

Right Knee Pain.  According to service treatment records (STRs) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right knee pain condition began in November 2007 timeframe with no specific injury or trauma identified.  The March 2008 MEB examination (recorded on DD Forms 2807-1 and 2808) 6 months prior to separation, reported complaints of continued right knee pain.  Physical examination showed decreased range of motion (ROM) of the right knee and tenderness.  The physical therapy (PT) examination on 02 April 2008, 5 months prior to separation, noted complaints of right knee pain with swelling.  Physical examination revealed a mildly antalgic gait and minimal effusion (fluid buildup) as well as tenderness of the knee.  Painful flexion and extension were noted, with strength recorded as 5/5.  The orthopedic examination on 24 April 2008, 4 months before separation, recorded knee tenderness.  ROM was not full, but there was no pain with motion.  Tests for instability and tearing of the cartilage were negative.  The 9 May 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of right knee pain rated 4-5/10 in severity, exacerbated by climbing stairs or ladders, kneeling or squatting.  The CI was unable to run comfortably, sit or stand for prolonged periods, drive for greater than 20 minutes, or carry heavy equipment or supplies.  Physical examination revealed no instability (negative Lachman).  ROM was recorded as 0-130 degrees (normal 0-140) with no change after repetition.  Painful motion was not addressed.  There was no VA Compensation and Pension examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 10%, coded 5099-5003 (arthritis, degenerative), citing painful motion.  The VA did not service connect the right knee condition, coded 5260 (leg, limitation of flexion) based on the CI’s STR, citing no evidence to determine if the CI’s diagnosis was related to military service.  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, as recorded at the PT examination.  There was no evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258) at separation.  There was no history of surgery to remove a meniscus (5259).  There was no fracture, non-union, or malunion of the femur or tibia to support consideration of the respective codes for knee impairment related to long bone conditions (5255, 5262).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded 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 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 re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150630, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170008877, XXXXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.

Sincerely,					      
						      					
Enclosure