RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01482
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040112

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Information Systems Operation Analyst, medically separated for “right knee pain secondary to iliotibial band syndrome” with a disability rating of 0%.  

CI CONTENTION:  Review for a higher rating.  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 (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 - 20031106	VARD - 20040211	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Pain Secondary to Iliotibial Band Syndrome	5024	0%	Iliotibial Band Tendonitis, Right Knee	5299-5257	10%	20030630	
	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Knee Pain Secondary to Iliotibial Band Syndrome.  According to the service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right knee condition began in June 2002 during a unit physical training run.  The CI was diagnosed with iliotibial band syndrome which initially improved with physical therapy. The knee pain ultimately became unresponsive to conservative treatment.  At the 12 February 2003 orthopedic evaluation, the CI reported persistent right knee pain with running.  The CI described the pain as a rubbing-type pain on the outer aspect of the right knee with motion.  Physical examination showed normal right lower extremity alignment and full range of motion (ROM).  There was mild tenderness at the posterolateral (back outer) knee and tenderness over the lower aspect of the iliotibial band. There was no effusion (swelling) or marked medial knee tenderness.  X-ray studies completed the same day showed bony structures intact.  On 31 March 2003, the CI refused steroid injections and possible surgical excision.

At the 30 June 2003 VA Compensation and Pension (C&P) physical examination, 7 months before separation, records showed right knee flexion to 130 degrees (normal 140) and tenderness along the iliotibial band.  The 20 October 2003 MEB NARSUM examination, 3 months prior to separation, noted reports of constant 4/10 pain and stiffness in the lateral aspect of the right knee, which increased to 7/10 with motion.  The abovementioned June 2003 C&P examination findings were referenced as the physical examination.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 0%, coded 5024 (tenosynovitis) citing full range of motion without joint instability.  The VA rated the right knee condition 10%, coded 5299-5257 (analogous to knee, other impairment), based on the C&P examination 7 months before separation, citing tenderness along the iliotibial band.  There was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  There was evidence of non-compensable limitation of knee motion and functional loss due to pain to support a 10% rating (based on §4.40 and §4.45) analogous to slight knee impairment (5257).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right knee condition, coded 5299-5257.  

BOARD FINDINGS:  In the matter of the right knee condition, the panel unanimously recommends a disability rating of 10%, coded 5299-5257 IAW VASRD §4.71a.  There were 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	
Right Knee Pain	5299-55257	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161011, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180001614, 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