RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX 	CASE:  PD-2015-02525
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070911

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Network Switch Systems Operator/Maintainer, medically separated for “chondromalacia causing left knee pain” with a disability rating of 10%.

CI CONTENTION:  Current condition supports a higher rating.  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 - 20070525	VARD - 20080708	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chondromalacia, Left Knee	5099-5003	10%	Degenerative Joint Disease, Left Knee	5010-5260	10%	20080610	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Chondromalacia, Left Knee.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI received a lateral meniscal repair in 1987 prior to entering the service.  The left knee was reinjured in July 2004 while performing physical training.  A left knee arthroscopy was performed in September 2005 resulting in a lateral meniscectomy.  In March 2006 he underwent a meniscal allograft transplant and an anterior cruciate ligament reconstruction.  Despite treatment the left knee could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty.

At the MEB NARSUM examination on 13 April 2007, 5 months prior to separation, the CI reported constant dull left knee pain which buckled after prolonged sitting.  The CI denied swelling and locking.  Physical examination showed no knee effusion.  There was hypersensitivity to light touch and tenderness to palpation over incision site.  Both instability and meniscus testing were negative.  Repetitive-goniometric range of motion (ROM) of extension to flexion was 0-110 degrees (normal 0-140); painful motion was not addressed.  During the 22 May 2007 MEB examination (recorded on DD Forms 2808 and 2807-1), 4 months prior to separation, the CI reported left knee to foot tingling and the use of a knee brace.  Physical examination showed an antalgic gait (slight left limp) and left knee tenderness.  Surgical portals and scars were healed.  Active ROM was extension to flexion of 0-110 degrees; painful motion was not addressed.

At the 10 June 2008 VA Compensation and Pension (C&P) joints evaluation, 6 months after separation, physical examination revealed no left knee crepitus and instability testing was negative.  ROM was extension to flexion of 0-120 degrees with painful motion.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left knee condition 10%, analogously coded 5099-5003 (degenerative arthritis).  The VA also rated the left knee condition 10%, analogously coded 5010-5260 (arthritis due to trauma - leg, limitation of flexion), based on the C&P examination 6 months after separation, citing painful motion.

Panel agreed there was no evidence proximate to separation of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There likewise was no limitation of motion which attained a 10% rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  There was no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions under code 5258.  There was a history of surgery to remove a meniscus (5259) to support a 10% rating under this code; however, this provided no rating advantage to the CI.  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.  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 chondromalacia, left knee condition.

BOARD FINDINGS:  In the matter of the chondromalacia, left 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 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 20151104, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170014674, 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.  

	A copy of this decision has been provided to the counsel you listed on your application.

Sincerely,					      
						      					
Enclosure