RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02837 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 active duty E5, Aviation Ordnance Systems Technician, medically separated for “bilateral knee patellofemoral chondrosis, surgically treated” rated 10% each, with a combined disability rating of 20%.

CI CONTENTION: In addition to requesting a review of all conditions, the CI requested review of 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 - 20050801	VARD - 20060308	
Condition	Code	Rating	Condition	Code	Rating	Exam	

Bilateral Knee Patellofemoral Chondrosis	
5299-
5003	

10+10=20%	Patellofemoral Syndrome with Retinaculum Tightness, Right Knee Status Post (S/P), Arthroscopy X 2	5259	10%	20060119	
			Patellofemoral Syndrome with
Retinaculum Tightness, Right Knee S/P, Arthroscopy	5259	10%	20060119	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Bilateral Knee Patellofemoral Chondrosis. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent two arthroscopic left knee surgeries, the last in December 2004, for lateral retinacular release and treatment of patellar chondrosis. He also underwent right knee arthroscopic surgery in May 2005 for release of the lateral retinaculum and was found to have stable ligaments with no evidence of meniscal injury. Despite the surgical procedures, full rehabilitation and use of medication and braces, he was unable to return to full duty in his military occupational specialty.

During the 21 June 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported knee pain. Physical examination revealed a great deal of

popping, crepitus (grinding sensation), a positive patellar grind test, and bilateral positive Lachman’s (to determine instability), and Apley compression tests (to determine a meniscal injury).

The 28 June 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of persistent pain in both knees with activity including running, sitting or prolonged standing. Physical examination showed bilateral knee range of motion (ROM) as 130 degrees flexion (normal 140) and normal extension of 0. On the left, there was a positive patellar grind and mild crepitance. On the right, the knee was stable to varus, valgus, and anterior and posterior stresses (to determine laxity and instability) with effusion, a positive 2+ patellar grind, and negative tilt testing.

At the 19 January 2006 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported severe unrelenting pain in both knees. Physical examination showed bilateral ROMs of 135 degrees flexion (examiner commented “normal”) and normal extension. On the left, Lachman’s and McMurray’s tests (to determine a meniscal tear) were negative; the examiner noted the patella was somewhat mobile, but did not dislocate. On the right, Lachman’s, McMurray’s, and drawer tests were negative, and there was some creaking of the right knee on flexion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right and left knee conditions 10% each, analogously coded 5099-5003 (degenerative arthritis). The VA also rated the right and left knee conditions 10% each, coded 5259 (cartilage, semilunar, removal of, symptomatic), based on the C&P examination, citing symptomatic removal of the semilunar cartilage. There was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261). However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §§4.59, 4.40 and 4.45) as adjudicated by the PEB. Alternatively, a 10% meniscal rating under code 5259 was considered, but was of no benefit to the CI as it includes painful motion. There was therefore no higher rating available under any applicable VASRD code than the 10% for each knee as 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 bilateral knee condition.

BOARD FINDINGS: In the matter of the bilateral knee patellofemoral chondrosis 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:

2	PD-2017-02837

DEPARTMENT OF THE NAVY
SECRETARY OF TI-IE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO,
1850
CORB: 003
10 Sep20

From: Director, Secretary of the Navy Council of Review Boards To:	

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno 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.