RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-02304
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20051130

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Ammunition Technician, medically separated for “[right] anterior knee pain consistent with anterior cruciate ligament [ACL] reconstruction” with a disability rating of 10%.

CI CONTENTION: Review requested of the right knee condition, which continues to worsen, as well as 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 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 - 20050928	VARD - 20060114	
Condition	Code	Rating	Condition	Code	Rating	Exam	
[Right] Anterior Knee Pain…	5299-5003	10%	
Status Post ACL Reconstruction, Right Knee	
5259	
10%	
20050927	
Status Post Right Knee ACL Reconstruction and Medial Meniscal Debridement	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Right Anterior Knee Pain. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent a right ACL reconstruction and partial medial meniscus tear repair in October 2004. There were no postoperative knee MRIs or X-rays in evidence. The 27 July 2005 MEB NARSUM, 4 months prior to separation, noted complaints of right knee pain. Physical examination showed no right knee tenderness and Lachman’s testing for instability was normal (1+ with a firm end point). Right knee flexion was to 140 degrees (normal) and extension to -5 degrees (5 degrees hyperextension (normal 0)); painful motion was not addressed.

During the 27 September 2005 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported constant right knee pain, but denied any periods of incapacitation or lost time from work.  Physical examination noted a normal gait without use of

an assistive device, and there was no right knee joint line tenderness, subluxation, locking pain, or joint effusion. There was tenderness over the anterior patella and patellar tendon as well as the surgical scar. The examiner found no evidence of instability or meniscal pathology, and right knee flexion was from 0-125 degrees, with painful motion. There was additional limitation due to pain, fatigue, weakness and lack of endurance following repetitive motion, but additional limitation in degrees could not be quantified without speculation.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right knee condition 10%, analogously coded “5299-5003” (degenerative arthritis), and listed “status post right knee ACL reconstruction and medial meniscal debridement” conditions as related diagnoses (Category II) contributing to the disability in this case. Based on the MEB NARSUM and VA examination evidence, the panel concluded the Category II diagnoses were not separate conditions which could be reasonably justified as separately unfitting. The VA also rated the right knee condition 10%, but coded 5259 (cartilage, semilunar (meniscus), removal of, symptomatic), based on the C&P examination, citing painful motion and crepitus. Panel members agreed that while there was no compensable limitation of flexion or extension (5260 or 5261), there was a history of meniscal surgery with a symptomatic right knee (5259) to warrant a 10% rating. The panel considered other VASRD knee and analogous codes, but all were less applicable and/or not advantageous for rating. There was therefore no higher rating than the 10% 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 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 20170221, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

2	PD-2017-02304

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 20May20

From: 

Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL  DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 10 Oct 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate action.

2.	On 20 March 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.

Copy to: PDBR