RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02859
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070603

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Information System Operator-Analyst, medically separated for “left knee pain” with a disability rating of 0%.

CI CONTENTION:  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’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 - 20070226	VARD - 20080628	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Knee Pain	5099-5003	0%	Left Knee Strain Status Post Surgery	5099-5019	10%	20070926	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Left Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left knee condition began in 2001 during basic training without a specific injury.  Over the next few years he was treated with medications and duty limitations which were sufficient to allow two deployments.  However, his symptoms progressed and an MRI on 27 February 2006 showed a left lateral meniscus tear.  The CI underwent an arthroscopic meniscal repair on 17 March 2006, but despite rehabilitative efforts, his persistent pain precluded a return to full activities.  

The 22 January 2007 MEB NARSUM examination, 7 months prior to separation, noted CI complaints of refractory left knee pain.  The actual physical examination was performed for the MEB by physical therapy on 22 January 2007, and revealed left knee ROM of 0-115 degrees (normal 0-140) after repetition and decreased due to pain (overall bilateral flexion was limited to 120 degrees bilaterally due to soft tissue impingement).   

At the 26 September 2007 VA Compensation and Pension (C&P) joint examination, 4 months after separation, the CI reported ongoing left knee pain aggravated by activity.  The physical examination showed a normal gait, stable knee and no atrophy.  Measured ROM was 0-145 degrees and equivalent to the right side, but painful.  There was no change with repetition.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left knee condition 0%, analogously coded 5099-5003 (arthritis, degenerative).  The VA rated the left knee condition 10%, analogously coded 5099-5019 (bursitis), based on the C&P examination, citing painful motion.  The record shows that the CI had a left lateral meniscectomy with persistent pain and limited motion, and members agreed that a 10% rating is supported under code 5259 (meniscus removal).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the left knee condition, coded 5259.  

BOARD FINDINGS:  In the matter of the left knee condition, the panel recommends a disability rating of 10%, coded 5259 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	
Left Knee Pain	5259	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170324, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180008225, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

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 

Sincerely,					      
Enclosure