RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2016-00188 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20091015

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Electronic/Mechanical Equipment Repairman, medically separated for “right knee patellofemoral syndrome s/p (status post) patellar subluxation times two” with a disability rating of 10%.

CI CONTENTION: “Please 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 Medical Evaluation Board (MEB), but determined by the PEB 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. The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate. The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.

RATING COMPARISON:

SERVICE PEB - 20090730	VARD - 20100809	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Patellofemoral Syndrome S/P Patellar Subluxation	5099-
5003	10%	Patellofemoral Syndrome Right Knee S/P Patellar Subluxation	5024-
5260	0%	20100511	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Right Knee Patellar Subluxation. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI injured his right knee during rescue swimmer’s school in September 2008. He sustained a right patella dislocation with swelling and pain. He reported that he self-reduced the dislocation. The 3 February 2009 primary care examination noted a 3- month history of right knee pain secondary to patellofemoral pain syndrome. The examiner noted that the first episode of patellar subluxation (versus dislocation) responded to physical therapy and activity modification. A second episode was reported after return to full duty. X- rays and other imaging studies were normal. Surgical intervention was not indicated. At the

10 February 2009 orthopedic examination the CI reported constant, throbbing 3/10 pain over the anterior aspect of the knee which worsened with weight bearing activities; especially walking and running. He occasionally wore a tracking sleeve. Physical examination showed atrophy of the vastus medialis obliques (quadriceps muscle directly above the patella). Right knee flexion was 135 degrees (normal 140 degrees) without painful motion. There was moderate pain at the lower edge of the patella and the patella apprehension test was positive.

The 20 April 2009 MEB NARSUM examination, 6 months before separation, noted complaints of constant throbbing right knee pain aggravated by walking and attempting to run; occasionally giving way with prolonged standing. Physical examination showed atrophy of the vastus medialis obliques. Right knee flexion was 135 degrees without painful motion. There was moderate pain at the lower edge of the patella and the patella apprehension test was positive.

At the 11 May 2010 VA Compensation and Pension (C&P) general examination, 7 months after separation, the CI reported right knee pain flare-ups 6 times weekly. He reported weakness, swelling, giving way, lack of endurance, locking, tenderness, subluxation, pain, and dislocation. He denied stiffness, heat, fatigability, deformity, or effusion. Physical examination showed no swelling, instability, subluxation, weakness, or guarding of movement. The gait was normal. Right knee flexion and extension were normal and pain free.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right patella condition 10%, analogously coded 5099-5003 (arthritis, degenerative). The VA did not service connect the right patella condition, analogously coded 5024-5260 (tenosynovitis-leg limitation of flexion), based on the C&P general examination, citing a non- compensable examination. The panel agreed there was no STR evidence of limitation of motion (5260, 5261) to support a rating higher than the 10% rating adjudicated by the PEB. There was no evidence of recurrent subluxation or lateral knee instability (5257), proximate to separation, to support a higher rating. After due deliberation, considering all 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 right knee condition.

BOARD FINDINGS: In the matter of the right patella condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication. There are no other conditions within the panel’s scope of review for consideration. Therefore, the panel recommends no modification or re- characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

2	PD-2016-00188

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO:
1850
CORB: 003
10 Sep 20

From: Director, Secretary of the Navy Council of Review Boards To:	

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.