RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02419
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20080215

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Rifleman, medically separated for “osteochondroma of the left distal femur” with a disability rating of 10%.

CI CONTENTION:  “Constant numbness in my leg from surgery, have reoccurring pain.”  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 at the time of separation.  The panel has neither the role nor the authority to compensate for progression or complications of service-connected conditions after separation.  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 - 20071121	VARD - 20080429	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Osteochondroma of the Left Distal Femur	5299-5255	10%	Residuals of Excision of Osteochondroma, Left Femur	5015-8526	10%	20080409	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Osteochondroma of the Left Distal Femur.    According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI developed left knee pain during a deployment to Iraq; and, on re-deployment he was diagnosed with an osteochondroma (benign tumor) of the distal femur.  He underwent surgical resection in February 2007, 12 months before separation.  

There were STR clinical entries that documented grossly normal range of motion (ROM) of the knee and hip, a normal gait, normal joint strength, and the absence of knee instability, effusion, or impingement.  There were no STR entries to the contrary, and none that documented any additional VASRD-ratable findings.  Surgical results were insufficient to allow unrestricted duty.  

The 19 October 2007 NARSUM examination, 4 months before separation, documented persistent nonspecific pain that prohibited rigorous Marine physical requirements.  The physical examination recorded a “slight” tenderness, “full” ROM of the knee, and the absence of knee instability or impingement.  

The 9 April 2008 VA Compensation and Pension (C&P) joint examination and the general C&P examination, 2 months after separation, documented constant pain rated 5/10, although the orthopedist asserted that there were no limitations on daily activities or any occupational disability.  The physical examinations recorded a normal gait, a tender surgical scar with no joint tenderness, normal joint strength, four-plane knee stability, and the absence of effusion or impingement.  Measured knee ROM measurements of the knee showed a flexion of 120 degrees (normal 140, 45 for minimum 10%) and a normal extension of 0 degrees, noting “mild discomfort” but no ROM degradation with repetition.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left femur condition 10%, analogously coded 5255 (femur, impairment of), with slight knee disability.  The VA rated the left femur condition 10%, dual coded 5015-8526 (benign-femoral nerve code), citing the applicable “mild” criterion of 8526.    

There was no minimum compensable ROM limitation, no persistent effusion and locking, and no evidence for any other ratable criterion in support of a rating higher than 10% under any applicable code.  The panel deliberated whether an alternate rating under the above criteria of code 5255 was supported.  Considering the functional impairment in evidence (limiting only rigorous activities per the NARSUM and minimal per the C&P), the panel agreed that the disability was better aligned with the “slight” 10% criterion than with the 20% “moderate.”  

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 left femur condition.

BOARD FINDINGS:  In the matter of the left femur 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 20150625, w/attachments
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 USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN

		
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