RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03465
BRANCH OF SERVICE:  AIR fORCE 	SEPARATION DATE:  20051223

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Security Forces Journeyman, medically separated for “right knee mechanical pain” with a disability rating of 10%.   

CI CONTENTION:  Condition affected employment.  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’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 - 20051104	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Mechanical Pain	5299-5257	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Right Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent two surgeries in 2000 and 2001 for right knee partial medial meniscectomies.  The CI reinjured his knee in 2004 and underwent a right knee scope synovectomy in May 2005.  At the time of the physical therapy clinic appointment on 8 July 2005, 6 months prior to separation, the range of motion (ROM) of the right knee was near normal (flexion of 135 vs normal of 140 degrees); however, the examiner noted this as “left knee ROM” which this panel opined as a mistake.  It was more likely than not the notation was intended to be documented as the right knee.  

The 9 August 2005 MEB NARSUM, 5 months prior to separation, noted that the right knee scope in May of 2005 did not show a medial meniscus tear nor evidence of any acute pathology.  The lateral meniscus was not torn and all ligaments were stable.  However, the CI reported pain and occasional locking.  His physical examination revealed no joint swelling or surrounding erythema.  Mild right quadriceps atrophy was present.  Right knee ROM was flexion of 120 degrees with normal extension.  Right knee tenderness was present.  At the time of a primary care appointment on 16 December 2005, 1 week prior to separation, the examiner reported normal sensation, normal strength, normal stance, normal gait, and normal reflexes.  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 10%, analogously coded 5257 (knee, other impairment of: recurrent subluxation or lateral instability).  There was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  The persistence of pain after meniscal surgery warranted a 10% rating under the 5259 code (cartilage, semilunar, removal of symptomatic), but the maximum 10% rating under that code provided no additional benefit to the CI.  There was no fracture, nonunion, or malunion of the femur or tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262).  There was therefore no VASRD §4.71a route to a rating higher than the 10% adjudicated by the PEB under any applicable code.  After due deliberation, considering all of 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 mechanical pain condition. 

BOARD FINDINGS:  In the matter of the right knee mechanical pain 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 20170515, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-03465.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						Sincerely,

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings