RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02668 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20050331

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Organizational Automotive Mechanic, medically separated for “patellofemoral syndrome, left knee” with a disability rating of 10%.

CI CONTENTION: The condition continues to worsen and negatively impacts daily activities. 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 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 - 20050110	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Patellofemoral Syndrome, Left Knee	8299-5003	10%	
No VA Examination Proximate to Separation in Evidence	
Chondromalacia, Left Knee	
Category II		
Acute Medial Meniscus Tears			
Joint Pain, Left Knee			
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Patellofemoral Syndrome, Left Knee. According to service treatment records (STR) and the MEB narrative summary (NARSUM), the CI underwent a second arthroscopic repair of a left knee meniscal tear in December 2003 (16 months before separation). Provider entries in the STR documented improving range of motion (ROM) after the final surgery. There were complaints of subjective locking, but multiple examiners noted the absence of any mechanical impingement and a post-operative MRI did not demonstrate any loose bodies. There was ample STR documentation of a normal gait without persistent effusion.

The 29 September 2004 MEB NARSUM examination, 6 months prior to separation, documented non-specific left knee pain prohibiting running and walking to 30 minutes. The CI denied having effusions, but complained of frequent subjective locking.      However, a subsequent orthopedic

note (2 months before separation) noted the CI denied “any mechanical locking.” The physical examination recorded a normal gait, “mild” tenderness, no note of effusion, no ratable instability, and no mechanical impingement. Measured ROM was flexion to 139 degrees (normal 140) and hyperextension of 10 degrees (normal 0), the latter a baseline bilateral finding. There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left knee condition 10%, analogously coded as 8299-5003 (degenerative arthritis). The PEB also listed chondromalacia, left knee; acute medial meniscus tears; and joint pain, left knee, as related Category II conditions (contributed to the primary unfitting condition but were not separately ratable). The impairment from these conditions was properly subsumed under the overall rating for the left knee to avoid pyramiding (§4.14). Diagnostic code 5259 (cartilage, semilunar, removal of, symptomatic) was applicable in this case, and provided for a 10% rating independent of any other criterion. The panel considered other VASRD knee and analogous codes, but all were less applicable and/or not advantageous for rating. 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 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 20170321, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

2	PD-2017-02668

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 <ltd 29 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.