RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  Pd-2016-00345
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20030902

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an National Guard E6, Motor Transport Operator, medically separated for “right knee pain” with a disability rating of 0%.  

CI CONTENTION:  The CI requested a review of 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 - 20030415	VARD - 20030912	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Pain…	5099-5003	0%	Right Knee Injury with Status Post Arthroscopy…	5010-5260	10%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10% 	

ANALYSIS SUMMARY:  

Right Knee Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI had a 20+ year history of knee pain beginning in 1981 after a twisting and planting injury which required arthroscopic surgery in November 2001.  The CI was mobilized on 12 February 2003 and was seen by orthopedics on 26 February 2003.  At that appointment, the CI reported locking, popping, and giving out.  On examination, flexion was limited by pain to 80 degrees (normal140) and normal extension.  The knee was stable without signs of meniscal irritation.  A patellar grind was positive bilaterally.  Motor function was normal.  He was thought to be non-deployable and referred for MEB with the diagnosis of degenerative joint disease (DJD).  During the MEB examination (recorded on DD Forms 2807 and 2808) dated 12 March 2003, 6 months prior to separation, the CI reported having problems with the knee locking up and giving out and the use of knee brace.  The physical examination showed swelling and limited flexion with pain.  The MEB NARSUM examination was 2 days later and noted complaints of locking, popping and giving out and that he no longer jump down from trucks.  The physical examination mirrored the orthopedic examination above.  X-rays revealed medial joint space narrowing with osteophytosis and there was also osteophytosis of the tibial spine on the right knee indicating a moderate degree of right knee DJD.  There was no VA examination in evidence proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 0%, coded 5099-5003 (arthritis, degenerative), citing it as a ‘slight/occasional’ condition.  The VA rated the right knee condition 10%, coded 5010-5260 (arthritis due to trauma and leg limitation of flexion of) based on the STR, citing X-ray evidence of degenerative joint disease and flexion to 80 degrees with pain.  There was no limitation of flexion or extension that supported a rating under the VASRD diagnostic codes for limitation of motion (5260 or 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 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 limited, painful motion supporting a 10% rating (based on §4.59).  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 5003.  

BOARD FINDINGS:  In the matter of the right knee condition, the panel unanimously recommends a disability rating of 10%, coded 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	
Right Knee Degenerative Arthritis	5003	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160602, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170015413, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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