RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00761
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20040514

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Air Transportation Journeyman, medically separated for “chronic right knee pain” with a disability rating of 20%.  

CI CONTENTION:  The CI’s knee condition continues to worsen and negatively impacts daily activities.  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 - 20040324	VARD - 20041023	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Knee Pain	5258	20%	S/P Medial Meniscus Tear Correction, Right Knee	5257	NSC*	STR	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  --	
*CI cancelled VA examination 5 October 2004 (subsequently award 10% day after separation on VARD 24 April 2009).

ANALYSIS SUMMARY:  

Chronic Right Knee Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent 2 right knee surgeries.  The first surgery took place in January 2003 for a partial meniscectomy.  The second surgery took place in October 2003 for a medial plica excision.  At a 30 December 2003 primary care clinic appointment the CI reported experiencing ongoing pain.  Examination revealed the CI walked with a normal gait, was not tender to palpation, showed no swelling and exhibited normal motor strength.  Range of motion (ROM) was considered “within normal limits.”  The MEB NARSUM, noted physical findings of full ROM, no tenderness, no instability, normal strength and walked with a normal gait.  
At the 13 February 2005 VA Compensation and Pension (C&P) evaluation, 9 months after separation, the CI reported stiffness, swelling, popping and constant pain.  Physical examination showed the CI walked with a normal gait, showed no instability and minimal crepitus (grinding).  The CI flexed his knee to 140 degrees (normal 140) and extended to 0 degrees (normal 0).  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 20%, coded 5258 (cartilage, semilunar, dislocated, with frequent episodes of locking, pain and effusion into the joint).  The VA determined the right knee condition was not service connected, coded 5257 (other impairment of the knee), citing no permanent residual or chronic disability was shown by the STR.  There was no evidence of marked knee disability to support a 30% rating under the 5262 code (tibia and fibula, impairment of).  There was no limitation of motion (5260, 5261) , and no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258) to support a rating under these respective codes.  The 5259 code (cartilage, semilunar, removal of, symptomatic) was applicable in this case but the maximum 10% rating under that code provided no benefit to the CI.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the right knee pain condition.  

BOARD FINDINGS:  In the matter of the chronic right knee pain 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 that 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 20160914, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00761.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  The Board recommended no re-characterization or modification of your separation.

I carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  I accept their recommendation that your application be denied.

Sincerely,

Attachment:
Record of Proceedings