RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2016-01617
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20041130

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Aviation Supply Specialist, medically separated for “right knee patellofemoral pain syndrome” with a disability rating of 10%.  

CI CONTENTION:  Review all conditions.  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 - 20040921	VARD - 20050906	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Patellofemoral Pain Syndrome	5299-5003	10%	Arthritis, Right Knee	5003	0%	20050607	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Knee Patellofemoral Pain Syndrome.  According to the service treatment record and the MEB narrative summary (NARSUM), the CI underwent right knee arthroscopic surgery in May 2004 for debridement of plica.  The 15 August 2004 MEB NARSUM examination, 3 months prior to separation, noted complaints of persistent right knee pain.  Physical examination showed tenderness, a positive patellar grind, and pain at the extremes of motion.  Right knee flexion was 120 degrees (normal 140).  During the 1 September 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the CI reported right knee pain.  Physical examination showed tenderness of the right peripatellar region with a positive patellar grind.  There was no effusion or swelling.  

At the 7 June 2005 VA Compensation and Pension (C&P) examination, 7 months after separation, the CI reported right knee pain with occasional giving out and swelling at night.  Physical examination showed right knee tenderness at the patellar tendon.  There was full but painful range of motion.  There was no instability or tenderness.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee patellofemoral pain syndrome 10%, analogously coded 5299-5003 (arthritis, degenerative).  The VA rated the right knee condition 0%, coded 5003 (arthritis, degenerative), based on the C&P examination, citing no evidence of painful or limited motion of a major joint.  

There was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §§4.59, 4.40, and 4.45).  There was no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258) to support a rating under that code.  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).  There was therefore no VASRD §4.71a route to a rating higher than the 10% adjudicated by the PEB under any applicable code.  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 patellofemoral pain syndrome.  

BOARD FINDINGS:  In the matter of the right knee patellofemoral pain syndrome 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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161024, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record  

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:

		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN

							XXXXXXXXXXXXXXXXXX
	     				                        Assistant General Counsel
						           (Manpower and Reserve Affairs)