RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01372
BRANCH OF SERVICE:  air force	SEPARATION DATE:  20040402

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, General Purpose Vehicle Mechanic, medically separated for “chronic right knee pain” with a disability rating of 10%.

CI CONTENTION:  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’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 - 20031118	VARD - 20040924	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Knee Pain	5003-5099 [sic]	10%	Chondromalacia, Right Knee	5014-5262	10%	20040724	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:

Right Knee.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right knee surgery (lateral release) in September 2002 due to non-traumatic chronic knee pain.  The 23 July 2003 MEB NARSUM examination, 9 months prior to separation, noted complaints of chronic right knee pain which was aggravated by standing, walking, and jogging.  .  Physical examination (PE) revealed a normal gait and right knee tenderness.   The examiner noted there was joint crepitus present with range of motion (ROM), but the examiner did not write a numerical quantification of the ROM.  An orthopedic evaluation on 5 November 2003, 5 months before separation, documented right knee pain and morning stiffness which was aggravated by running or maneuvering stairs.  ROM was extension to 0 degrees (normal) and flexion was 130 degrees (normal 140); painful motion was not addressed. 

At the 7 July 2004 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported chronic right knee pain which prevented him from squatting, prolonged standing, bending, lifting, and doing vehicle maintenance work.  The PE revealed right knee tenderness without swelling.  ROM remained unchanged from the orthopedic examination 8 months earlier.  Crepitus was present and painful motion was not addressed.  Right knee stability tests were noted as “stable”.  X-rays taken that day revealed a normal knee.  

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 also rated the right knee condition 10%, dual coded 5014-5262 (osteomalacia-tibia and fibula, impairment), based on the C&P examination, citing malunion of the tibia and fibula with slight knee or ankle disability. 

The panel agreed there was no objective evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There likewise was no limitation of motion which attained a 10% 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).  No additional functional limitation was evidenced by the examinations.  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.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170226, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-01372.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						Sincerely,

	

								XXXXXXXXXXXXXXXXXX								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings