RECORD OF PROCEEDINGS
PHYSICAL DISABILITY PANELOF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01767
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040316

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a National Guard E4, Light Wheel Vehicle Mechanic, medically separated for “chronic left knee pain” with a disability rating of 10%.

CI CONTENTION:  “I am in constant pain, some days worse than others.  Review all 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 - 20040129	VARD  N/A	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Knee Pain	5099-5003	10%	No VA examination in evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: N/A	

ANALYSIS SUMMARY:  

Chronic Left Knee Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left knee condition began in October 2001 after a hyperextension injury.  She was treated with duty limitations, medications, and a knee brace, but her pain persisted.  An MRI in January 2002 was normal.  Over the course of the next 2 years, she was followed in orthopedics and treated with medications and injections, but was unable to return to full duty and was referred to MEB.  

During the July 2003 MEB examination (recorded on DD Forms 2807-1 and 2808), accomplished 8 months prior to separation, the CI reported problems with walking fast or running because of left knee pain and swelling.  The physical examination showed mild effusion, tenderness, and decreased ROM (range of motion).  At the 7 November 2003 MEB NARSUM examination, 4 months prior to separation, the CI reported that pain prevented her from running, walking more than half a mile, and standing for greater than 15 minutes.  The physical examination showed a normal gait.  Tenderness was present over a bursa, but there was normal patella tracking, no swelling, and stable ligaments.  The ROM was full but painful.  There was no VA Compensation and Pension (C&P) evaluation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left knee condition 10%, analogously coded 5003 (arthritis, degenerative), citing full ROM, no joint laxity, no focal neurovascular deficits, and slight and constant pain.  There was evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45) as adjudicated by the PEB under the code 5260 (limitation in flexion).  There was no evidence for meniscal damage or instability to support a higher rating.  The panel noted that the use of the 5003 code is dependent upon X-ray evidence of arthritis which was not apparent.  The code 5260 does allow the assignment of a 10% rating for painful motion, but there is no advantage to the CI for this recommendation.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the chronic left knee condition.

BOARD FINDINGS:  In the matter of the chronic left knee condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel 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/attachments
Exhibit B.  Service Treatment Record

AR20170008802, XXXXXXXXXXXXXXXXXX 

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Dear XXXXXXXXXXXXXXXXXX:

	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