RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01696
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20020517

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Ground Radio Repairer, medically separated for “right knee pain, status post medial meniscal repair” with a disability rating of 10%.  

CI CONTENTION:  His knee condition continues to worsen and negatively impact daily activities.  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 - 20020315	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Pain, Status Post Medial Meniscal Repair	5259	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Right Knee Pain…  According to the service treatment record and the MEB narrative summary (NARSUM), the CI underwent right knee surgery in September 2001 for a torn medial meniscus.  He did well post surgery but re-injured his knee approximately 6 weeks later.  He reported increased knee pain, swelling, and intermittent catching.  A physical therapy (PT) visit on 4 February 2002 noted an antalgic gait.  Knee range of motion (ROM) was normal flexion and extension.  There was tenderness of the medial joint line and pain with meniscal testing (positive Apley’s maneuver).  The CI was offered a second surgery for a possible re-torn meniscus, but chose to continue conservative treatment.  

During the 11 February 2002 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported right knee pain, swelling, catching, locking, and giving out.  Physical examination showed tenderness of the medial joint line with effusion and a positive Apley’s test.  The 4 March 2002 MEB NARSUM examination, 2 months prior to separation, noted a complaint of right knee pain.  The CI reported catching posteriorly with deep knee bends and anterior medial joint line (MJL) pain.  The examiner noted there was no catching or locking at the anterior MJL.  Physical examination showed well healed portal and MJL incisions.  Knee ROM was 140 degrees of flexion and full extension as compared with 150 degrees of flexion of the unaffected left leg.  There was tenderness of the anterior MJL, but not posterior.  The examiner noted no swelling or obvious displacement of the meniscus at the MJL.  There was painless crepitus with ROM and no evidence of instability.  

At a PT visit on 5 March 2002 the CI reported no pain for several hours after PT treatments.  He continued to report catching with deep squats.  Physical examination showed an antalgic gait favoring the right.  Knee flexion was 140 degrees and extension was limited by 5 degrees.  There was tenderness of the MJL and quadriceps muscle atrophy on the right compared to the left, with normal strength reported.  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 10%, coded 5259 (cartilage, semilunar, removal of, symptomatic).  There was persistence of pain after meniscal surgery to support a 10% rating under the 5259 code as adjudicated by the PEB.  The panel considered alternative VASRD knee and analogous codes, but all were less applicable and/or not advantageous to 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 knee pain, status post medial meniscal repair 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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161031, w/atchs
Exhibit B.  Service Treatment 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)