RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXX	CASE: PD-2016-00040
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20011110

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Wheeled Vehicle Repairer, medically separated for “chronic pain, left knee” with a disability rating of 10%.

CI CONTENTION: The CI contends for 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 - 20010829		VARD - 20040121	
Condition	Code	Rating		Condition	Code	Rating	Exam	
Left Knee	5099-5003	10%		Patellofemoral Syndrome, Left Knee	5099-5003	10%	STR	
COMBINED RATING: 10%		COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Chronic Left Knee Pain. According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI noted the acute onset of left knee pain in October 1999, but denied any specific injury. An MRI on 26 July 2000 showed mild degenerative changes of the lateral meniscus. Surgery was not indicated.

The 6 July 2001 MEB NARSUM examination, 4 months prior to separation, noted complaints of a constant dull ache which was aggravated by activity. The physical examination showed a normal gait. The knee was stable and signs of meniscal irritation were absent. The range of motion (ROM) was full and pain free.  There was mild tenderness on the medial inferior aspect of the

knee just below the left patella. There was no VA Compensation and Pension evaluation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left knee condition 10%, coded 5099-5003 (arthritis, degenerative), citing application of the Army Physical Disability Agency pain policy. The VA also rated the left knee condition 10%, coded 5099-5003, based on the STR, citing degenerative changes shown on the MRI and painful motion as evidenced by restrictions on activities. There was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261). 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 those 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 there was insufficient cause to recommend a change in the PEB adjudication for the left knee condition.

BOARD FINDINGS: In the matter of the 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 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 20160119, w/atchs Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record

AR20170013200, 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,