RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-03462
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20061130

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E-4, Ground Communications Organizational Repairer, medically separated for “right knee ACL [anterior cruciate ligament] tear, status post [S/P] reconstruction” with a disability rating of 20%.

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 - 20060822	VARD - 20070507	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee ACL Tear…	5299-5262	20%	

Degenerative Joint Disease Right Knee	

5261	

10%	

20070306	
Lateral Meniscal Tear, S/P Partial Lateral Meniscectomy	Cat II					
Chondromalacia of Tibial Plateau, Medial and Lateral, S/P Chondroplasty	Cat II					
Right Knee medial Meniscal Tear, S/P Partial Meniscectomy	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Right Knee ACL Tear. According to the service treatment record and MEB narrative summary (NARSUM), the CI injured his right knee while playing basketball and underwent a right ACL

reconstruction on 20 April 2005. He additionally required partial medial and lateral meniscectomies and chondroplasty of the right knee tibial plateaus. At the 3 January 2006 orthopedic examination, 8 months post-surgery and 11 months prior to separation, the CI had some anterior knee pain, and a "grating sound” with full extension. The physical examination (PE) noted right knee joint line tenderness and decreased range of motion (ROM) with flexion to 90 degrees (normal 140) and normal extension. The 27 July 2006 MEB NARSUM examination, 4 months before separation, noted complaints of right knee pain. The PE revealed flexion to 95 degrees with normal extension. A mild joint effusion was present as well as joint line tenderness, but tests for joint instability were negative. During the August 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), the CI reported a constantly swollen right knee. Physical examination showed positive crepitus, a positive McMurray’s test combined with meniscal damage, and decreased right knee flexion.

At the 6 March 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI complained of chronic right knee swelling aggravated by increased physical activities.  The PE revealed right knee flexion to 120 degrees and extension to 5 degrees  (normal 0). There was mild swelling about the right knee without effusion. Again, instability tests were negative and the joint line tenderness remained.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right knee condition 20%, analogously coded 5299-5262 (tibia and fibula, impairment). Panel members agreed that the three additional Category II (contribute to the primary unfitting condition but not separately ratable) diagnoses were intertwined with the overall knee impairment and properly subsumed by the PEB under the ACL tear condition. More than one rating based on the same primary impaired condition is prohibited, IAW §4.14 (avoidance of pyramiding). The VA rated the right knee condition 10%, coded 5261 (leg, limitation of extension), based on the C&P examination, citing consideration of strength, speed, coordination, endurance, weakness, fatigability, incoordination, swelling, deformity, instability, atrophy, pain on movement, flare ups, or functional loss due to pain. There was no evidence of marked knee disability (5262); no severe degree of limited motion (5260, 5261); and no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258) to support a higher rating under these respective codes. While code 5259 (cartilage, semilunar, removal of, symptomatic) was applicable in this case, the maximum 10% rating provided no benefit to the CI. 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 right knee condition.

BOARD FINDINGS: In the matter of the right 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.

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) PDBRltr

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 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.