RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2016-00483
BRANCH OF SERVICE:  marine corps	SEPARATION DATE:  20030930

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Basic Aircraft Maintenance Marine, medically separated for “right knee patellofemoral syndrome with a right anterior cruciate strain” with a disability rating of 10%.

CI CONTENTION:  The knee condition has impacted his “way of life and has not gotten better since discharge.”  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 - 20030815	VARD - 20040413	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Patellofemoral Syndrome…	5299-5003	10%	Right Knee Lateral Plica	5260	0%	20040309	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Right Knee Patellofemoral Syndrome.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s right knee pain began in November 2002 after running.  He was treated with physical therapy, activity modification and a trial of nonsteroidal anti-inflammatory medication without relief, and a right knee MRI in 2003 revealed a possible anterior cruciate ligament strain or partial tear.  Surgery was not indicated.

The 26 March 2003 MEB NARSUM examination, 6 months prior to separation, noted CI complaints of constant right knee pain with the inability to run.  Physical examination showed a normal gait and pain with patellar grind testing.  Right knee range of motion (ROM) was “full,” but painful motion was not addressed.  During the 3 April 2003 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months before separation, the CI reported persistent knee pain, and physical examination showed no effusion, crepitus or deformity.  The provider recorded “full” ROM, but painful motion was not mentioned.  

At the 13 April 2004 VA Compensation and Pension (C&P) examination, 7 months after separation, the CI reported right knee pain with prolonged walking, standing or squatting.  Physical examination showed a normal gait, and no tenderness, swelling, effusion, quadriceps atrophy, retropatellar crepitation or patellar instability.  Flexion was 140 degrees (normal) and extension was 0 degrees (normal), without pain.  The examiner noted a persistent popping sensation around the patella and assessed a possible plica (fold in thin lining around knee joint). 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 10%, analogously coded “5299-5003” (arthritis, degenerative).  The VA rated the right knee condition 0%, coded 5260 (leg, limitation of flexion), based on the C&P examination, citing a non-compensable examination.  Members agreed there was no STR or VA evidence of:  limitation of motion (5260, 5261), history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258), meniscal surgery (5259), or fracture, nonunion or malunion of the femur or tibia causing a knee impairment (5255, 5262), to support a 10% rating under those codes.  Additionally, there was insufficient evidence of painful motion to support a 10% rating IAW §4.59, however, the panel may not recommend a disability rating lower than that adjudicated by the PEB.  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 knee patellofemoral syndrome 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.

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS Ref: (a) DoDI 6040.44
In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual's records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy's Physical Evaluation Board: