RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00869
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040512

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Fire Support Specialist, medically separated for “right knee pain,” with a disability rating of 0%.

CI CONTENTION:  The CI made no specific contention.  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 - 20040129	VARD - 20040622	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Pain	5099-5024	0%	Right Patellar Tendonitis	5024-5260	10%	20040311	
RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Knee Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s “right knee pain” began in April 2002 without specific injury.  Orthopedics planned to perform arthroscopy, but the procedure was deferred due to deployment.  Magnetic Resonance Imaging (MRI) dated 3 September 2003 showed no significant findings of the knee.  X-ray on 10 September 2003 showed normal radiographic examination of the knee.  The 29 October 2003 MEB NARSUM examination, 7 months prior to separation, noted complaints of right knee pain that did not respond to anti-inflammatory pain relievers, physical therapy and rest.  The CI was able to perform the physical fitness test with alternative events of walking and swimming, but was issued a profile that limited his ability to run, ruck, road march and climb.  
Physical examination showed full ROM with mild tenderness to palpation (TTP).  He was neurovascular intact, with normal reflexes.  At the 11 March 2004 VA Compensation and Pension (C&P) evaluation 2 months before separation, the CI reported chronic pain without relief from medication.  Physical examination showed normal ROM and no pain with motion noted.  Examination tests for ligamentous instability and meniscus pathology were negative.  There was slight swelling of the infrapatellar and suprapatellar areas.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the “right knee pain” 0%, coded 5099-5024 (analogous to tenosynovitis), citing no evidence for a minimum rating.  The VA rated the “right patellar tendonitis” condition 10%, coded 5024-5260 (tenosynovitis analogous to leg, limitation of flexion of:  limited to 45 degrees), based on the C&P examination 2 months before separation.  

There was no evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There likewise was no limitation of motion which attained a minimum rating under the diagnostic codes for limitation of flexion or extension (5260, 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 mal union of the femur or tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262).  No additional functional limitation was evidenced by the examinations.  Therefore the panel concluded there was not sufficient evidence to support a rating higher than the 0% adjudicated by the PEB.  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 “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 20160918, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170017178, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.

Sincerely,					      
						      					
Enclosure