RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXX	CASE: PD-2017-03588
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060305

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Wheeled Vehicle Mechanic, medically separated for “left knee pain” with disability rating of 10%.

CI CONTENTION: Review was requested 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 - 20060125	VARD - 20070131	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Knee Pain	5099 5003	10%	Left Knee Strain	5257-5024	10%	20060501	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 60%	

ANALYSIS SUMMARY:

Left Knee Pain. According to the service treatment record and MEB narrative summary, the CI’s left knee condition began in 2003 with no associated traumatic injury. An MRI in April 2005 showed a tear of the anterior horn of lateral meniscus. He underwent arthroscopic lateral meniscectomy surgery in June 2005. X-rays of the left knee performed in May 2005 were normal. A follow-up MRI performed in November 2005 revealed mild retropatellar effusion and was otherwise unremarkable.

During the 11 January 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the examiner noted tenderness and no swelling. Physical examination showed left knee range of motion (ROM) measurements with flexion of 80 degrees (normal 140). The MEB NARSUM examination 2 days later noted complaints of persistent pain. The examiner found negative anterior and posterior drawer and negative Lachman’s test. He had normal muscle strength of the left knee with flexion/extension. There was positive tenderness noted around the patella but no swelling. Physical examination showed left knee ROM measurements of flexion 110 degrees and extension 0 degree (normal).

At the 1 May 2006 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported stiff sharp pain, weakness and give way. The examiner found stability to all ligaments. Left knee flexion was 125 degrees and 0 degrees of extension with ROM limited by pain after repetitive use. After repetitive use, his joint function was not additionally limited by fatigue, weakness, lack of endurance and incoordination. X-rays performed the same day showed no evidence for fracture or other significant bone or soft tissue abnormality.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left knee condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing moderate and occasional pain. The VA also rated the left knee condition 10%, dual coded 5257-5024 (knee, other impairment - tenosynovitis), based on the C&P examination, citing left knee flexion was painful and slightly limited to 125 degrees flexion. Extension was full and painless at 0 degrees. The panel agreed there was no limitation of flexion or extension that supported a rating under the VASRD diagnostic codes for limitation of motion (5260 or 5261). However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §§4.59, 4.40 and 4.45). 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). The 5259 code (cartilage, semilunar, removal of, symptomatic) was applicable in this case but the maximum 10% rating under that code 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 left knee condition.

BOARD FINDINGS: In the matter of the left 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.

PD-2017-03588

AR20190010679, XXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXX

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.

PD-2017-03588