RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01374
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070522

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Patriot Fire Control Operator medically separated for “chronic right knee pain” with a disability rating of 0%.   

CI CONTENTION:  “I was not hurt before I went in to the Army.”  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 at the time of separation.  The panel has neither the role nor the authority to compensate for progression or complications of service-connected conditions after separation.  That role and authority is granted by Congress to the Department of Veterans Affairs (VA), 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 - 20070501	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Knee Pain	5099-5003	0%	No VA Examination in Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Right Knee Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right knee condition began in April 2006 after he fell down a flight of stairs.  Orthopedics reported the CI was not a surgical candidate.  A bone scan on 1 February 2007 was normal.  At the time of the primary care clinic appointment on 7 February 2007, 4 months prior to separation, the CI reported right knee pain on a pain scale of 10/10 and stated that he has been having constant pain on both of his knees.  Physical examination showed tenderness of medial aspect of knee, pain with varus and valgus stressing, and full range of motion (ROM) without pain.  

During the 25 February 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported his knee continued to hurt, give-out, pop and lock.  Physical examination showed an antalgic gait in toe-tip, heel, and duck walk efforts.  He was barely able to weight-bear on right lower extremity and could not rise from bent knee position without assistance of left lower extremity.  The examiner reported that right knee was further impacted by a motor vehicle collision (MVC) in February 2007.  X-rays taken on 8 February 2007 after the MVC, were normal.  

The 14 March 2007 MEB NARSUM, 2 months prior to separation, noted the CI had an antalgic gait.  Physical examination showed the medial aspect and mediopatellar plica were tender on palpation.  ROM measurements at physical therapy on 16 March 2007, showed a flexion of 90 degrees (normal 140) and an extension of -15 (normal 0), limited by pain.  There was no VA Compensation and Pension evaluation 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%, analogously coded 5003 (arthritis, degenerative), citing the US Army Physical Disability Agency pain policy (AR 635-40), slight/frequent.  There was no history or evidence 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 those codes.  There was no fracture, nonunion 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 limitation of extension that supported a rating under the VASRD diagnostic code for limitation of motion 5261.  The physical therapy ROM examination recorded right knee extension limited to -15 degrees following repetitive motion which supported a 20% rating under code 5261 (extension limited to 15 degrees).  There was no limitation of flexion that supported a minimum rating under the VASRD diagnostic code for limitation of flexion (5260).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the chronic right knee pain condition, coded 5261.  

BOARD FINDINGS:  In the matter of the chronic right knee pain condition, the panel unanimously recommends a disability rating of 20%, coded 5261 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	
Chronic Right Knee Pain	5261	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160105, w/attachments
Exhibit B.  Service Treatment Record

AR20180001407, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

	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