RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02581
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20071219

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty, Automated Logistical Specialist, medically separated for “right lateral meniscectomy and subsequent cartilage transplant” with a disability rating of 10%.  

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 - 20070822	VARD - 20080707	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Lateral Meniscectomy	5259	10%	Degenerative Arthritis of the Right Knee	5003	0%	20080314	
Allergic Rhinitis	Not Unfitting	Allergic Rhinitis	6522	0%	20080314	
Low Back Pain	Not Unfitting	Degenerative arthritis, Thoracic Spine	5242	10%	20080314	
Neck Pain	Not Unfitting	No VA Placement	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Lateral Meniscectomy and Subsequent Cartilage Transplant.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent a right knee meniscectomy in May 2005 and a meniscal transplant in April 2006.  At an evaluation in orthopedics on 9 March 2007, the CI reported that he was able to walk, ride a bike and play some basketball, but was not able to return to full duty.  On examination, right knee extension was limited to 3 degrees (normal 0) and flexion to 110 degrees (normal 140).  The motion of the left knee was normal.  Signs of lateral meniscal irritation were present, but the knee was stable and without significant swelling.  X-rays showed normal post-operative changes without evidence of osteoarthritis. 

The 29 March 2007 MEB NARSUM examination, 9 months prior to separation, noted complaints of daily pain and subjective instability.  Range of motion was from 0-105 degrees (normal 0-140) and limited by pain.  The knee was stable, but maneuvers for meniscal irritation were positive.  The CI was seen in orthopedics in follow-up on 16 May 2007.  His symptoms were unchanged, although flexion had improved to 120 degrees.  Quadriceps atrophy was present.  He reported buckling of the knee, but it was stable on examination.  Joint line tenderness (suggestive of meniscal pathology) was negative.  

At the 14 March 2008 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported persistent right knee pain which was aggravated by activity.  On examination, the gait and posture were normal.  No assistive device was in use and signs of abnormal weight bearing were absent.  The knee was stable and signs of meniscal irritation were absent.  Flexion was limited to 120 degrees with the onset of pain at 110 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 10%, coded 5259 (cartilage, semilunar, removal of, symptomatic), citing limitation of functional activities.  The VA rated the right knee condition 0%, coded 5003 (degenerative arthritis), based on the C&P examination, citing lack of objective evidence of painful or limited motion of a major joint.  The panel agreed the non-compensable limitation of motion under code 5003 supported a 10% rating, as did the symptomatic post-surgical meniscus under code 5259.  There was no ankylosis, instability or sufficient limitation in motion to support a higher 20% rating.  After due deliberation, considering all of 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.  

Contended PEB Conditions:  Allergic Rhinitis, Low Back Pain and Neck Pain.  The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting.  None of the conditions were profiled or implicated in the commander’s statement.  All were judged to meet retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions, so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the right knee condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended allergic rhinitis, back pain and neck pain conditions, the panel recommends no change from the PEB determinations as not unfitting.  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 20170426, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180008667, 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