RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX		CASE: PD-2017-02757 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20061128

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Petroleum Supply Specialist, medically separated for “patellofemoral arthritis, right knee” with a disability rating of 0%.

CI CONTENTION: Knee injury requires pain killers and has affected the hips. 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 - 20060823	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Patellofemoral Arthritis, Right Knee	5003	0%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Right Knee Patellofemoral Arthritis. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right knee condition began while playing high school football. The entry physical showed normal knees and was silent for knee problems, but he experienced significant right knee pain and swelling during basic training. An MRI showed chondromalacia and an X-ray revealed an inferior patellar spur. At physical therapy visits on 12 May and 22 June 2008, right knee range of motion (ROM) was noted as “abnormal,” with painful motion.

During the 12 June 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported right knee joint problems at the patella with early arthritis. Physical examination demonstrated right knee tenderness as well as pain with squatting, but normal heel-to-toe walking, and no patellar defects, meniscal signs or laxity.

The 19 July 2006 MEB NARSUM, 4 months before separation, noted CI complaints of chronic right knee pain. Physical examination showed bilateral moderate genu valgum (knee knocking) but no instability;  meniscal  testing  was  not  addressed.    The  9  August  2006  MEB  orthopedic    re-

examination for right knee ROM recorded flexion to 95 degrees (normal 140) and extension to 0 degrees (normal). Painful motion was not addressed. 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 right knee condition 0%, coded 5003 (degenerative arthritis), citing a stable knee and active ROM of 0-95 degrees. Panel members agreed that while there was no compensable limitation of flexion or extension (5260, 5261), there was satisfactory evidence of painful motion with functional loss to support a 10% rating IAW §4.59, §4.40 and §4.45, as recorded on the PT examinations proximate to separation. There was no evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258); history of cartilage (meniscus) removal surgery (5259); or fracture, nonunion or malunion of the femur or tibia causing a knee impairment (5255, 5262) to support a rating under those codes. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right knee condition, coded 5003.

BOARD FINDINGS: In the matter of the right knee condition, the panel recommends a disability rating of 10%, coded 5003 IAW VASRD §4.71a. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Patellofemoral Arthritis, Right Knee	5003	10%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170326, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

	

AR20190013201, XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXX

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs. 

2	PD-2017-02757