RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02319
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050401

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Power Generator Equipment Repairer, medically separated for “chronic right knee pain” with a disability rating of 0%.

CI CONTENTION:  “Knee is not as strong as before.  Pain is constant.” 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 - 20050131	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Knee Pain	5099-5003	0%	No VA Examination in Evidence Proximate to Separation	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:  

Chronic Right Knee Pain.  According to the service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right knee pain began in June 2004 after fracturing his lateral tibia subchondral in April 2004.  An MRI in July 2004 recorded a non-displaced lateral tibial subchondral fracture and medical tibial plateau contusion.  Another MRI in October 2004 was reported to be normal. There was no surgical indication, and conservative treatment did not result in improvement sufficient to allow unrestricted duty.  

At the time of the orthopedic clinic appointment on 22 November 2004, the CI reported pain in the right lateral (outer) knee.  Physical examination showed an inward turn of the lower leg from the knee to foot on observation and with ambulation.  There was tenderness “without the quadriceps muscle contracted” and upon palpation of the biceps femoris tendon.  There was no joint line tenderness of the patellar tendon.  Motion was noted to be normal.  Posterior/anterior drawer signs were negative.  

At the 29 November 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 9 months prior to separation, the CI reported right knee pain.  Physical examination showed lateral collateral ligament tenderness and patellar crepitus.  The examiner rendered a diagnosis of tendonitis or lateral collateral ligament strain of the right knee.  

The 10 December 2004 MEB NARSUM examination, 4 months prior to separation, noted complaints of unresolved right knee pain.  Physical examination showed pain with varus and valgus stress, but no tenderness of any anatomical position within the right knee.  There was no laxity, clicking, popping or catching.  Strength was normal.  Range of motion was “normal” without pain; however, measurements recorded flexion of 135 degrees (normal 140) and extension of 0 degrees (normal).  The examiner characterized the condition as chronic pain and fatigue of the right knee.  There was no VA 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 0%, coded 5099-5003 (arthritis, degenerative), citing full range of motion without joint instability.  There was no limitation of motion which attained a minimum rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  There was no residual fracture, nonunion, or malunion of the femur or tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262).  No additional functional limitation was evidenced by the examinations.  Although there was an abnormal gait, the evidence did not support a 10% rating for painful motion IAW §4.59 (painful motion.  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 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 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 20150813, w/atchs
Exhibit B.  Service Treatment Record

AR20170015262, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

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