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From:
To:

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD DC 20374-5023
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Director, Secretary of the Navy Council of Review Boards
PD-2017-00553

IN REPL'(  REFER TO

1850
CORB:003
27 Feb 20

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)
Ref:	(a) DoDI 6040.44
(b) PDBR ltr of 28 Oct 19

1.	Pursuant to reference (a), the POBR reviewed your case and forwarded its recommendation to the Department of the Navy for appropriate   action.

2.	On 21 February 2020, the Assistant General Counsel of the Navy (Manpower & Reserve  Affairs)  took action in  your case by    accepting  the recommendation of  the PDBR.	Accordingly,  your records will be corrected  to reflect   an increase in the disability rating awarded by the Department of the Navy Physical
Evaluation Board (PEB) from 0% to 10% without re-characterization of your discharge.

3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	The Assistant Secretary's determination, which represents final action  in  your case by the Department of the Navy, has been forwarded to the Navy Personnel Command for appropriate changes to your personnel  records and notification  to  you  upon completion.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX		CASE: PD-2017-00553 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20060727

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Boatswain’s Mate, medically separated for “chronic left knee pain/patella femoral pain” with a disability rating of 0%.

CI CONTENTION: “Can’t get jobs that require strenuous activities.” The CI requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 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 - 20060414	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Knee Pain	5099-5003	0%	No VA Examination Proximate to Separation	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Chronic Left Knee Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent left knee surgery in February 2005 which revealed normal articular cartilage,  intact  anterior  cruciate  ligament,  and  intact  medical  and  lateral  menisci.    The    5 December 2005 MEB NARSUM, 8 months prior to separation, noted complaints of left knee pain. Physical examination revealed left knee flexion of 135 degrees (normal 140) and extension of 0 degrees (normal) without evidence of painful motion. Provocative testing to elicit meniscal pathology was negative. At the sports medicine examination on 8 March 2006, 5 months before separation, the CI complained of left knee pain with giving way and sudden locking. Physical examination showed left knee tenderness without weakness. Left knee motion and movement were “normal,” but there was painful motion. Left knee MRI in April 2006 showed articular surface irregularity of the medial femoral condyle and a small joint effusion.

During the 13 November 2006 VA orthopedic examination, 4 months after separation, physical examination revealed “full” range of motion.      Provocative testing for meniscal pathology was

positive and left knee X-rays showed a probable torn left lateral meniscus. There was no VA Compensation and Pension examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left knee condition 0%, analogously coded 5099-5003 (degenerative arthritis). There was no limitation of flexion or extension that supported a rating under the VASRD diagnostic codes for limitation of motion (5260 or 5261). 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 evidence of painful motion with functional loss supporting a 10% rating (based on
§4.59, §4.40 and §4.45). After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the left knee condition, coded 5099-5003.

BOARD FINDINGS: In the matter of the left knee condition, the panel recommends a disability rating of 10%, coded 5099-5003 IAW VASRD §4.71a. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Left Knee Pain/Patella Femoral Pain	5099-5003	10%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170214, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

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