RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-00765
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070117

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Infantryman, medically separated for “chronic right knee pain” with a disability rating of 0%.

CI CONTENTION:  Review of all conditions requested.  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 - 20061107	VARD - 20080319	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Knee Pain	5099-5003	0%	Right Knee Iliotibial Band Syndrome	5260	10%	20071106	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right knee condition began approximately in April 2005 when he felt pain after a run.  A right knee MRI in July 2005 indicated mild iliotibial band (ITB) friction syndrome and minimal patellar degenerative changes.  The swelling subsided in a few days and the pain was intermittent.  Following a road march in February 2006 the right knee pain was aggravated.  Right knee X-rays in March 2006 were normal.  A right knee MRI in March 2006 showed mild ITB friction syndrome.  Right knee X-rays in June 2006 were within normal limits.
At the 24 July 2006 MEB orthopedic consultation, 6 months prior to separation, the CI reported knee swelling with activity and pain going up and down stairs, with giving way without frank catching or locking.  Physical examination revealed right knee ITB tenderness.  Patellar grind and apprehension tests were negative.  There was no evidence of instability or meniscal pathology.  Right knee range of motion (ROM) was normal and equal to the unaffected left knee.  Painful motion was not addressed.  The 13 September 2006 MEB NARSUM examination, 6 months prior to separation, noted complaint of constant right knee pain and cited the examination of the 24 July 2006 orthopedic MEB consultation summarized above.  

At the 6 November 2007 VA Compensation and Pension (C&P) examination, 10 months after separation, the CI reported the right knee gave out occasionally and he fell a few times, but he was not currently treated for the condition.  He reported he had no pain on the day of the examination, however, he experienced flare-ups that lasted several days during cold weather.  On physical examination, his gait was normal.  The right knee ROM following repetitive movement was flexion of 128 degrees (normal 140) and normal extension of 0 degrees, with painful motion and mild crepitus, and a loss of 10 degrees flexion due to pain with repetitive motion.  There was clicking of the lateral knee with motion, lateral and inferior to the patella.  There was no evidence of instability.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 0%, analogously coded 5099-5003 (degenerative arthritis), with application of the US Army Physical Disability Agency pain policy.  The VA rated the right knee condition 10%, based on the C&P examination, citing painful motion.

The panel agreed there was no limitation of flexion or extension (5260, 5261) or objective evidence of painful motion with functional loss, proximate to separation, to support a 10% rating (based on §4.59, §4.40 and §4.45).  There was no evidence of dislocated meniscus or loss body causing frequent locking with recurrent effusions (5258), no meniscal surgery (5259), or fracture, nonunion or malunion of the femur or tibia causing a knee impairment (5255, 5262) to support a rating under those codes. 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 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.  

AR20190000566, XXXXXXXXXXXXXXXXXX. 

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.