RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02578
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050617

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Chemical Operations Specialist, medically separated for “chronic pain, right knee” with a disability rating of 0%.

CI CONTENTION:  “Increased pain and immobility.”  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 – 20050513	VARD - 20060817	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain, Right Knee	5099-5003	0%	Retropatellar Pain Syndrome, Right Knee	5024	10%	20060707	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Right Knee Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right knee condition began in August 2002 during basic training without reported trauma.  An arthroscopic medial plica resection of the right knee was performed in April 2003.  Despite non-steroidal anti-inflammatory drugs and physical therapy the CI’s condition could not be adequately rehabilitated.   

The 3 May 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of right knee pain.  She could not perform basic soldiering activities: road march, run, extended walks or physical fitness test without pain.  Physical examination revealed a normal gait with 5/5 motor strength while meniscus testing was negative.  Range of motion (ROM) was 0 to 135 degrees (extension to flexion (normal 0 to 140)); painful motion was not addressed.  

The 7 July 2006 VA Compensation and Pension (C&P) joints examination, 13 months after separation, noted complaints of retropatellar pain syndrome worsened by running or prolonged sitting.  Physical examination revealed ROM was 0 to 135 degrees; there was pain at the limits of motion but painful motion with functional loss was not addressed.  There was no additional loss of ROM, pain, weakness, incoordination or lack of endurance due to repetition.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee 0%, coded 5099-5003 (analogous to degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA rated the right knee condition 10%, coded 5257 (knee, other impairment), based on the C&P examination 13 months after separation, citing pain on use.  

Panel members agreed there was no limitation of flexion or extension that supported a minimum rating under the respective codes (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 these 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).  Although on one examination there was evidence of pain at the end of motion, there was no evidence of painful motion with functional loss to justify a minimum rating IAW VASRD §4.59.  

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 chronic right knee pain condition.

BOARD FINDINGS:  In the matter of the chronic right knee pain 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 20150519, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170013331, 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