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Dear XXXXXXXXXX:

I accept the recommendation of the Department of Defense Physical Disability Board of Review (DoD PDBR) to re-characterize your separation as a disability retirement with the combined disability rating of 30% effective the date of your medical separation for disability with Reserve retirement.  Enclosed is a copy of the Board’s recommendation and record of proceedings for your information.

	The re-characterization of your separation as a disability retirement will result in an adjustment to your pay providing retirement pay from the date of your original medical separation.
 
	The accepted DoD PDBR recommendation has been forwarded to the Army Physical Disability Agency for required correction of records and then to the U.S. Defense Finance and Accounting Service to make the necessary adjustment to your pay and allowances.  These agencies will provide you with official notification by mail as soon as the directed corrections have been made and will provide information on your retirement benefits.  Due to the large number of cases in process, please be advised that it may be several months before you receive notification that the corrections are completed and pay adjusted.  Inquiry concerning your correction of records should be addressed to the U.S. Army Physical Disability Agency, (AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557.

	A copy of this decision has also been provided to the Department of Veterans Affairs.

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-03756
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060616

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a National Guard E6, Construction Engineer Supervisor, medically separated for “chronic right knee pain” with a disability rating of 10%.  

CI CONTENTION:  No specific contention was made.  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 - 20060327	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Knee Pain	5003	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Right Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent a partial medial meniscectomy on 12 November 2004 with chondroplasty of the medial femoral condyle and removal of osteophytes.  

The 18 April 2006 orthopedic surgeon evaluation, 2 months prior to separation, the examiner stated the CI “had significant grade IV chondromalacia noted in the trochlea as well as in the medial compartment.  [The CI] had failed conservative treatment measures and [would] proceed with a total knee arthroplasty.”  The 4 May 2006 orthopedic operative report, approximately 1 month prior to separation, reported knee implants were cemented into place without complications.  X‑rays showed right knee patellar, femoral and tibial implants cemented in place.  There was a suprapatellar drain.  There was no sponge or fracture.    

At the orthopedic examination on 7 June 2006, 5 weeks after surgery and 1 week prior to separation, the CI reported that he was doing well, but still had some soreness and pain.  On examination, he walked with a slight antalgic gait.  The ROM was 0-118 degrees and the knee was ligamentously stable.  There was an effusion, but the examiner noted it was consistent with the post-operative course.  X-rays indicated the right knee was in good position with no evidence of loosening. 

The 30 May 2007 orthopedic follow-up, 11 months after separation, noted the CI had no complaints and was doing well.  On examination, his gait was non-antalgic and ROM was from slightly hyper-extended to 130 degrees of flexion.  The knee was stable and the patella tracked “nicely.”  The orthopedic surgeon stated the CI was doing well following his right knee total knee arthroplasty.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 10%, coded 5003 (degenerative arthritis), citing “radiographic evidence of degenerative joint disease and slight loss of motion.”  The panel noted the CI underwent a total knee replacement on 4 May 2006 and IAW VASRD code 5055 (knee replacement [prosthesis]) would be rated at 30% minimum.  A higher evaluation of 60 percent is not warranted unless evidence demonstrates chronic residuals consisting of severe painful motion or weakness in the affected extremity.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 30% for the right knee condition status post total knee replacement, coded 5055.  

BOARD FINDINGS:  In the matter of the right knee condition, the panel recommends a disability rating of 30%, coded 5055 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; and, that the discharge with severance pay be re-characterized to reflect permanent disability retirement, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Status Post Total Right Knee Replacement	5055	30%	

The following documentary evidence was considered: