RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2016-00911
BRANCH OF SERVICE:  Navy	SEPARATION DATE:  20050120

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Gas Turbine Mechanic Main Technician, medically separated for “right recurrent patellar subluxation” with a disability rating of 10%.

CI CONTENTION:  Knee pain and numbness have negatively affected his low back and hip.  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 - 20041129	VARD (Vocational Rehabilitation) - 20050323	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Recurrent Patellar Subluxation	5299-5003	10%	Recurrent Right Knee Patella Subluxation	5260	NA	NA	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:

Right Recurrent Patellar Subluxation.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s right knee condition began in March 2002 after a fall during ship duty.  The patella was relocated via closed reduction and treated conservatively with physical therapy. On 14 July 2004, the CI underwent right patella realignment surgery.

A physical therapy evaluation on 31 August 2004, 2 months after surgery and 5 months before separation, revealed “full” right knee range of motion (ROM); painful motion was not addressed.  At an orthopedic visit on 14 October 2004, 3 months after surgery and 3 months before separation, there was patellar tenderness, with right knee flexion to 135 degrees (normal 140) and extension to -5 degrees (normal 0); painful motion was not mentioned.  

The 14 October 2004 MEB NARSUM examination noted CI complaints of continued right knee pain, and the provider recorded right patellar tendon tenderness.  Knee ROM was “full;” painful motion was not addressed.  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 patella condition 10%, analogously coded 5099-5003 (arthritis, degenerative).  Members 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.  Additionally, there was no evidence of meniscal surgery (5259), no dislocated meniscus or loss body causing frequent locking with recurrent effusions (5258), and no fracture, nonunion or malunion of the femur or tibia causing a knee impairment (5255, 5262) to support a higher rating.  Lastly, there was no evidence of “moderate” 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 recurrent patellar subluxation 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.

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: