RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2016-00077
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040105

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, UAV Operator, medically separated for “osteochondral defect of medial femoral condyle (right)” with a disability rating of 0%.  

CI CONTENTION:  “Review all conditions.”  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 – 20031022	VARD - 20040303	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Osteochondral Defect of Medial Femoral Condyle (Right) 	5099-5003	0%	S/P Arthroscopic Debridement and Chondromalacia, Right Knee	5260-5014	10%	20031202	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Osteochondral Defect of Medial Femoral Condyle (Right).  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent right knee surgery in November 2002 for a suspected medial meniscal tear.  Although a meniscal tear was not present, there was grade II chondromalacia over the medial femoral condyle with fibrocartilage overgrowth.  This osteochondral defect was debrided back to stable cartilage.  The 27 August 2003 MEB NARSUM examination, 5 months prior to separation, noted complaints of anterior and medial-based pain in the right knee with stair climbing, prolonged walking, running, or prolonged sitting.  Physical examination showed a well-healed surgical incision with no evidence of effusion but some quad atrophy on the right side when compared to the left.  He had “fairly notable” tenderness to palpation of the medial femoral condyle with the knee partially flexed and extended.  Range of motion (ROM) was recorded as flexion to 135 degrees (normal 140) and extension to 0 degrees (normal).  Painful motion was not addressed.  X-ray examination revealed a very mild osseous defect along the medial femoral condyle with no evidence of degenerative arthritis.  

At the 3 December 2003 VA Compensation and Pension (C&P) evaluation, performed 1 month before separation, the CI reported occasional use of a cane (not prescribed) and loss of strength in his right knee as well as occasional swelling.  Physical examination showed a well healed and nontender scar with no ligamentous instability, swelling, tenderness, or joint effusion.  ROM was recorded as extension to 0 degrees and flexion to 130 degrees with painful motion beginning at 110 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 0%, coded 5099-5003 (analogous to degenerative arthritis), citing full ROM and no ligamentous laxity.  The VA rated the right knee condition 10% coded 5260-5014 (osteomalacia), based on the VA C&P examination 1 month before separation, citing painful motion.  There was no limitation of flexion or extension that supported a 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, 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).  However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right knee condition, coded 5099-5003.  

BOARD FINDINGS:  In the matter of the right knee condition, the panel unanimously recommends a disability rating of 10%, coded 5099-5003 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  The panel recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Osteochondral Defect of Medial Femoral Condyle (Right) 	5099-5003	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160207, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170013284

Dear XXXXXXXXXX

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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 also been provided to the Department of Veterans Affairs.

Sincerely,	
Enclosure