RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02538
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20081217

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Basic Trainee, medically separated for “patellofemoral pain syndrome of left knee” with a disability rating of 10%.  

CI CONTENTION:  The CI made no specific contention.  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 - 20081205	VARD - 20090220	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Patellofemoral Pain Syndrome, Left Knee	5099-5003	10%	Left Knee	5003	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Left Knee Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left knee pain condition began in June 2008 while walking up a flight of stairs he felt a pop.  This was aggravated one week later by basic training activities:  six mile ruck march following a four mile run.  Radiographic imagining (X-ray) of the left knee in August 2008 were normal.  Despite 30 days of convalescent leave and 4 months of physical therapy the CI’s condition could not be adequately rehabilitated to allow him to finish training.  

A troop medical clinic on 05 August 2008, 5 months before separation, revealed a normal left knee examination without pain elicited by motion.  A physical therapy examination on 11 September 2008, 3 months before separation, revealed a normal knee examination with normal range of motion (ROM) without painful motion.  

The 19 November 2008 MEB NARSUM examination, 1 months prior to separation, ROM was recorded as extension to 0 (normal) and flexion to 140 degrees (normal) without painful motion.  

There was no VA Compensation and Pension (C&P) examination performed within 12 months post-separation for this panel to review.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left knee 0%, coded 5099-5003 (analogous to degenerative arthritis), citing painful motion.  The VA rated the left knee condition 0% coded 5003 (degenerative arthritis), based on the STR, citing the CI did not report to his C&P examination so they were unable to determine the extent, if any, of his current symptoms.  

Panel members agreed there was no limitation of flexion or extension that supported a minimum rating under the VASRD diagnostic codes for limitation of motion (5260 or 5261).  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, 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).  There was no evidence of painful motion in examinations proximate to separation to provide for a minimum rating IAW VASRD §4.59, painful motion.  

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 left knee pain condition.  

BOARD FINDINGS:  In the matter of the patellofemoral pain syndrome of 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 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 20151113, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170013315, XXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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