RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXX	CASE: PD-2017-03754
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20080105

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Aircraft Powerplant Repairer, medically separated for “chronic left knee chondromalacia” with a disability rating of 0%.

CI CONTENTION:  Review all conditions.  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 - 20071015	VARD – 20090225	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Knee Chondromalacia	5099-5003	0%	Left Knee Strain	5299-5261	10%	20090217	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Chronic Left Knee Chondromalacia. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent a left knee arthroscopy with debridement for chondromalacia, chondral abrasion, and a lateral meniscal tear on 4 April 2007.   During the      17 July 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, physical examination revealed a stable left knee with anterior pain.

The 28 August 2007 MEB NARSUM examination, 4 months before separation, noted complaints of pain 4 days a week and especially at night and with stairs. Physical examination showed well- healed  arthroscopic  portals  with  a  mild  effusion,  joint  line  tenderness,  and  pain      during

patellofemoral compression. Left knee range of motion (ROM) tests showed flexion to 125 degrees (normal 140) and extension to 0 degrees (normal).

At the 17 February 2009 VA Compensation and Pension (C&P) examination, 13 months after separation, the CI reported periodic left knee pain. Physical examination showed tenderness, and after repetition, flexion was to 140 degrees and extension to 0 degrees, with painful motion.

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 (degenerative arthritis), citing the US Army Physical Disability Agency Policy/Guidance Memorandum #12, dated 28 February 2005. The VA rated the left knee condition 10%, analogously coded 5299-5261 (leg, limitation of extension of), based on the C&P examination, citing objective evidence of left knee painful motion with tenderness on the medial and lateral patella. Panel members agreed there was no compensable limitation of flexion or extension (5260 or 5261); history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258); or 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). However, there was evidence of painful motion with functional loss supporting a 10% rating (based on
§4.59, §4.40 and §4.45). Code 5259 (cartilage, semilunar, removal of, symptomatic) was also applicable in this case, and provided an alternate route to a 10% rating. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the left knee condition, coded 5099-5003.

BOARD FINDINGS: In the matter of the left knee condition, the panel recommends a disability rating of 10%, coded 5003 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	
Chronic Left Knee Chondromalacia	5099-5003	10%	

The following documentary evidence was considered:

	PD-2017-03754
AR20190012662, XXXXXXXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXX

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.

	PD-2017-03754

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