DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309 WASHINGTON NAVY YARD, DC 20374

IN   REPLY   REFER TO:
1850
CORB:003
20 Feb 20·

From: To:

Director, Secretary of the Navy Council of Review Boards PD-2017-00149

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 21 Sep 18

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy.

2.	On 12 February 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-00149
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20051115

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Low Altitude Air Defense Gunner, medically separated for “left knee open reduction and internal fixation [ORIF]” with a disability rating of 20%.

CI CONTENTION: “Between my left knee and my back, it has seemed to affect everything I do and changes the way that I bend, kneel and stoop.”  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 - 20050822	VARD - 20060512	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Knee ORIF	5299-5255	20%	Left Knee Osteochondral Lesion	5003-5261	10%	20060330	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Left Knee. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent left knee surgery in December 2004 to reattach, with two Accutrak screws, a large osteochondral fragment which had detached from the medial femoral condyle.    At the    9 June 2005 physical therapy clinic appointment, 5 months prior to separation, the CI reported no pain with walking, but when he climbed stairs or slopes his knee pain went to 6/10. He also complained of left knee numbness. On examination the CI had good patella mobility and normal hamstring strength. The left knee range of motion (ROM) evaluation showed flexion of 131 degrees (normal 140) and extension of 0 degrees (normal).

During the 28 June 2005 MEB NARSUM examination, 5 months prior to separation, the CI stated he experienced sharp left knee pain when he attempted to run. He also complained of knee pain with any type of weight bearing. Physical examination showed a mild effusion and tenderness over the medial femoral condyle. Strength of the left knee was normal and it was ligamentously stable. The ROM study showed left knee flexion of 130 degrees and extension of 0 degrees.

At the 30 March 2006 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI complained of left knee pain with soreness and intermittent swelling, but denied locking, clicking, or popping. He wore a sleeve that seemed to help, but he still could not run or jump. Physical examination showed a normal gait, but there was mild puffiness on the medial aspect of the left knee. Strength and reflexes were normal and there was no instability. Left knee ROM testing showed painless flexion of 140 degrees and painless extension of 2 degrees. The examiner estimated the CI would have an additional 10 or 15 degrees of loss of motion due to repetitive motion, but did not specify if the limitation affected flexion or extension. X-rays revealed mild osteoarthritis of the left knee and slight narrowing of the medial compartment with joint effusion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left knee condition 20%, analogously coded 5299-5255 (femur, impairment of). The VA rated the left knee condition 10%, dual coded 5003-5261 (degenerative arthritis causing limitation of extension), based on the C&P examination, citing objective findings of painful and/or limited motion due to knee disability. There was no evidence of marked knee disability to support a 30% rating under the 5255 code and no limitation of motion (5260, 5261) to support a rating of 30%. 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 left knee condition.

BOARD FINDINGS: In the matter of the left knee 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 20170115, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

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