RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02103
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060510

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

CI CONTENTION:  The condition continues to worsen.  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 - 20060306	VARD – 20060519 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Knee Pain 	5099-5003	0%	Left Knee Patellofemoral Osteoarthritis	5010-5260	10%	20060331	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10% 	

ANALYSIS SUMMARY:  

Left Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left knee pain began in August 2002 when he sustained a blow to the knee while exiting a helicopter.  On 16 December 2004, he underwent a diagnostic arthroscopy with patellar articular cartilage debridement, lateral retinaculum release and a plicectomy.  The surgery was well tolerated and without incident.  The 12 December 2005 MEB NARSUM examination, 5 months prior to separation, noted the CI was able to walk approximately 1 mile without pain, but was unable to run, ruck, jump, march or perform strenuous physical activities.  On examination, left knee range of motion (ROM) showed flexion to 135 degrees (normal 140) and extension to -5 degrees (normal 0).  There was tenderness, but no meniscal signs.  

At the 31 March 2006 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported that he could running slowly on a treadmill although sometimes his knees appeared red afterwards.  Kneeling was still painful and when he bended the knee, it popped.  On examination, gait was normal with no signs of meniscal pathology or instability.  Flexion was to 120 degrees and extension to 0 degrees, and there was crepitus with motion. 

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), citing ROM within acceptable norms and no evidence of joint laxity.  The VA rated the left knee condition 10%, analogously coded 5010-5260 (leg, limitation of flexion), citing painful or limited motion of a major joint, or group of minor joints. Members agreed there was no evidence of limitation of flexion or extension which attained a 10% rating under codes 5260 or 5261.  Additionally, there was no objective painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There was no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258); no history of surgery to remove a meniscus (5259); and 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 and thus no rating higher than the 0% adjudicated by the PEB.  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 left knee condition.  

BOARD FINDINGS:  In the matter of the left knee pain 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 20170309, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180016339, 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.

Sincerely,					       

Enclosure