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

IN REPLY REFER TO

1850
CORB:003
12 Feb 20

Director, Secretary of the Navy Council of Review Boards 
PD-2017-01141

Subj: Ref:

PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

(a) DoDI 6040.44
(b)	PDBR ltr dtd 5 Feb 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy of 15 October 2019 for appropriate action.

2.	On 31 January 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: XXXXXXXXXXXXXXXX	CASE: PD-2017-01141
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20080516

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E4, Culinary Specialist, medically separated for “right knee patellofemoral pain syndrome” with a disability rating of 10%.

CI CONTENTION: The condition continues to worsen and negatively affects 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 - 20080225	VARD - 20090706	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Patellofemoral Pain Syndrome	5299-5003	10%	Right Knee, Patellofemoral Syndrome	5299-5261	0%	20081030	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 60%	

ANALYSIS SUMMARY:

Right Knee Patellofemoral Pain Syndrome. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right knee condition began in November 2006 after playing flag football. Radiographic studies were normal and there was no surgical indication. The 16 January 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of pain with squatting, running and climbing. Physical examination showed painful varus and valgus testing at 0 and 30 degrees, but the knee was stable. The McMurray's test produced medial knee

pain, as did the duck walk. A Lachman’s test produced no increased translation and a good endpoint.  The CI had parapatellar pain with duck walk.

During the 5 February 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported the right knee was giving-out and wore a knee brace to keep it stable. There was pain with flexion and extension. The examiner noted the CI wore a sports brace and was attending orthopedic sports medicine.

At the 30 October 2008 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported weakness, stiffness and pain with prolonged standing or walking. Physical examination showed a normal gait. The ROM evaluation showed 140 degrees of flexion (normal) and extension of 0 degrees (normal). There was no limitation of motion due to pain, fatigue, weakness, lack of endurance or incoordination after repetition.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right knee condition 10%, analogously coded 5003 (degenerative arthritis). The VA rated the right knee condition 0%, analogously coded 5261 (limitation of extension), based on the C&P examination, citing a non-compensable evaluation.

There was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 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). There was therefore no VASRD §4.71a 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 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.