RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01337
BRANCH OF SERVICE:  ARMY	SEPARATION DATE:  20070730

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Small Arms Repairman, medically separated for “right knee pain” with a disability rating of 0%.  

CI CONTENTION:  “Review all conditions.”  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 – 20070706	VARD - 20080409	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Pain	5099-5003	0%	Post-Operative Residuals, Partial Medial Meniscectomy with Patella Chondromalacia, Right Knee 	5259	10%	20080307	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Right Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right knee surgery in October 2003 for meniscal pathology but continued to have increasing pain over time.  During the 8 May 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, he reported right knee pain.  Physical examination showed no instability and “good range of motion and tender with palpation overall.”  The 18 May 2007 MEB NARSUM examination, 2 months before separation, noted CI complaints of constant, dull pain behind the kneecap rated at 1/10 increasing to 10/10 with activity, but no locking or mechanical symptoms.  Physical examination showed a normal gait, reflexes, muscle strength and sensation, and “full” range of motion.  The medial aspect of the knee was tender with no swelling, edema, erythema or warmth.  At the 21 June 2007 PT MEB ROM evaluation, after repetition, right knee flexion was 130 degrees (normal 140), with pain, and extension was 0 degrees (normal).
 
At the 7 March 2008 VA Compensation and Pension (C&P) evaluation, 8 months after separation, the CI complained of anterior right knee pain rated at 8/10, with a history of intermittent swelling and popping.  Physical examination showed flexion to 120 degrees and extension to 0 degrees with no pain or change with repetition.  There was no tenderness, effusion, erythema, infection or edema, or muscle loss.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 0%, coded 5099-5003 (arthritis, degenerative), citing full range of motion.  The VA rated the right knee condition 10%, coded 5259 (cartilage, semilunar removal of, symptomatic), based on the C&P evaluation, citing symptomatic removal of the semilunar cartilage.  Members agreed there was no limitation of flexion or extension that supported a rating under the VASRD diagnostic codes 5260 or 5261.  The examinations proximate to separation did not demonstrate the presence of ligamentous instability or laxity (5257), and there was no history of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258) to support a rating under the respective codes.  There was no fracture, non-union, 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 meniscus surgery supporting a 10% rating (5259, cartilage, semilunar, removal of, symptomatic).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right knee condition, coded 5259.  

BOARD FINDINGS:  In the matter of the right knee pain condition, the panel recommends a disability rating of 10%, coded 5259 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 as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Right Knee	5259	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170225, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record  

AR20180004945, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs 

Sincerely,					      
Enclosure