RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01996
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070606

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Security Forces Helper, medically separated for “chronic left patellar tendonitis associated with shin splints” with a disability rating of 10%.  

CI CONTENTION:  “I was honorably discharged but did not follow up with the VA.”  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 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 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 - 20070427	VARD - 20071009	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Patellar Tendonitis Associated with Shin Splints	5024-5003	10%	Chronic Patellar Tendonitis L Knee…	5257	0%	STR	
			Bilateral Shin Splints	5262	0%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Left Knee Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI leg pain began in August 2006 while in technical school.  She was thought to have shin splints and treated with duty limitations and physical therapy (PT).  X-rays of the bilateral lower leg bones (tibiae and fibulae) were normal on 19 September 2006.  A bone scan on 6 October 2006 showed stress changes, but stress fractures.  She also noted left knee pain diagnosed as patellofemoral syndrome (PFS).  She had some improvement with activity limitations, but had recurrent symptoms following increased activity.  An MRI of the left knee on 27 February 2007 showed edema consistent with a bone bruise on the left shin just below the knee and some degeneration of the cartilage of the left kneecap.  She was evaluated in orthopedics on 14 March 2007.  She was tender over the patellar ligament, but had full motion and a stable knee.  She had pain with resisted extension.  An MEB was recommended to allow the CI’s symptoms to resolve with the expectation that she could return in 6-12 months to complete training.  Her prognosis was thought to be excellent.  The MEB forwarded “chronic patellar tendonitis and shin splints” for PEB adjudication.  The MEB NARSUM examination on 20 March 2007, 3 months prior to separation, noted complaints of left knee joint pain.  The physical examination showed no dislocation, no pain, and no tenderness to palpation and no muscle spasm of the knee. The left knee had full and pain free range of motion (ROM).  The knee was stable and the gait normal.  The examination was otherwise unremarkable.  It was recommended that she be separated or reclassified.  The CI failed to report for the VA Compensation and Pension (C&P) evaluations proximate to separation.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left knee 10%, analogously coded 5024-5003 (degenerative arthritis).  The VA rated the left knee 0% coded 5257 (knee, other impairment) and 0% coded 5262 (tibia and fibula, impairment), as the CI did not report for the C&P evaluations.  The knee showed full and pain free ROM with stable knees.  The gait was also normal.  The Board found no route to a rating higher than the 10% adjudicated by the PEB.  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 pain.  

BOARD FINDINGS:  In the matter of the left knee pain 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 20150701, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-01996.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings