RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01954
BRANCH OF SERVICE:  MARINE CORPS 	SEPARATION DATE:  20070630

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

CI CONTENTION:  “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 - 20070413	VARD - 20080212	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Patellofemoral Pain Syndrome	5099-5003	10%	Right Knee Sprain	5010	10%	20080121	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Patellofemoral Pain Syndrome.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI suffered an atraumatic onset of right knee pain in December 2004 during basic training.  Imaging (MRI) did not demonstrate any significant pathology (ligaments and menisci intact, no surgical indications).  Clinical entries in the STR documented a full range of motion (ROM) with notation of painful motion.  There were no STR entries that suggested any significant ROM limitation, persistent effusion and locking, instability or any other VASRD-ratable findings.

The 5 February 2007 NARSUM examination, 5 months prior to separation, documented non‑‑specific pain that was exacerbated by prolonged sitting or standing, lifting, and stairs; and, that prohibited running.  The CI specifically denied subjective instability.  The physical examination recorded the absence of tenderness, stability to stress testing and negative signs of impingement.  The ROM measurements were flexion to 140 degrees (normal 140) and minus 3 degrees extension (normal 0), specifying pain with flexion.  

The 21 January 2008 VA Compensation and Pension (C&P) evaluation, 7 months after separation, documented constant pain rated 8/10 with subjective instability that was “elicited by physical activity.”  The physical examination recorded a normal gait, absence of tenderness or effusion, stability to stress testing and negative signs of impingement.  The ROM measurements were flexion to 125 degrees with 0 degrees extension, specifying pain but no ROM degradation with repetition.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB’s 10% rating under code 5099-5003 (analogous to degenerative arthritis).  The VA rated the right knee sprain condition 10%, coded 5010 (traumatic arthritis, defaulting to criteria of 5003) based on the C&P examination 7 months after separation, citing limited motion of a major joint.  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 of the right knee condition.  

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 are 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 20150713, 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

      In accordance with reference (a), I have reviewed the cases listed below and 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:

		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
	 	- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC

		
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