RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXX	CASE: PD-2015-02430
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20080716

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Wheeled Vehicle Mechanic, medically separated for “right knee pain” with a disability rating of 10%.

CI CONTENTION:   The CI details that his knee is consistently getting worse.	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 - 20080410		VARD – NA	
Condition	Code	Rating		Condition	Code	Rating	Exam	
Chrondromalacia Right Knee	5099-5003	10%		No VA Exam in Evidence	
COMBINED RATING: 10%		COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Chrondromalacia Right Knee. According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the right knee condition began in September 2005 after a twisting injury during a run. Radiographic studies (MRI in March 2006 and X-rays in January 2007) showed chondromalacia (abnormal cartilage) and arthritis (osteophyte/bone spur formation), respectively. At the (7 & 14) November 2007 MEB examination (recorded on DD Forms 2807 and 2808), 8 months prior to separation, the CI reported locking, instability, and pain with walking, bending, and getting up from the ground. The physical examination showed anterior knee tenderness and grinding. At a 14 January 2008 physical therapy visit, 6 months prior to separation, the physical examination showed crepitus

with compression and tenderness of the patellar tendon. There was full range of motion (ROM), pain with squat, and no evidence of effusion.  At the 3 March 2008 MEB NARSUM examination, 4 months prior to separation, the CI reported intermittent locking; intermittent pain worsened by cold weather, maneuvering stairs, running, jumping and marching; and denied instability. The physical examination showed tenderness of the superior and inferior patella, crepitus, and decreased ROM secondary to pain. Flexion was to 110 degrees (normal 140), and extension was to 0 degrees (normal). There was normal strength and no evidence of swelling, muscle atrophy, or ligamentous instability or laxity. There was no VA Compensation and Pension (C&P) evaluation in evidence proximate to separation.

The panel directed attention to the rating recommendation based on the above evidence. The PEB rated 10% for the knee condition, coded 5099-5003 (degenerative arthritis), citing subjective locking, with pain limited ROM and no instability. There was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261). However, 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. The examinations proximate to separation did not demonstrate the presence of ligamentous instability or laxity (5257), and there was no history of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258), or history of surgery to remove a meniscus (5259) to support a rating under the respective codes. There was no fracture, non-union, or malunion of the femur or tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262). There was therefore no VASRD §4.71a route to a rating higher than the 10% adjudicated by the PEB under any applicable code, and no grounds for additional rating based on the presence of instability. 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 right knee condition.

BOARD FINDINGS: In the matter of the right knee pain condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication. There were no other conditions within the panel’s scope of review for consideration. The panel, 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 20151006, w/atchs Exhibit B. Service Treatment Record

AR20170012912, 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,