RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX	CASE:  PD-2017-03855
BRANCH OF SERVICE:  army	SEPARATION DATE:  20080601

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an E3, Motor Transport Operator, medically separated for “chronic left knee pain” with a disability rating of 0%.

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 - 20080319	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Knee Pain	5099-5003	0%	No VA Examination in Evidence 	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Right Knee Pain.  According to the MEB NARSUM and service treatment record the CI underwent left knee surgery in August 2007 for the excision of medial plica (a fold in the thin tissue that lines the knee joint that can become irritated) that caused knee pain.  Additionally, the medial and lateral menisci were inspected and found to be anatomically normal.  Despite physical therapy, profiling and activity modification, the left knee pain resumed with running.  No further surgery was recommended.  

The 1 October 2007 MEB NARSUM orthopedic examination, 8 months prior to separation, noted complaints of left knee discomfort, catching sensation, pain, and stiffness.  Physical examination showed left knee mild patellofemoral crepitus and inferior pole tenderness without effusion.  Left knee flexion was 130 degrees (normal 140) and extension of 0 degrees (normal).  Painful motion was not addressed.  X-rays on 7 October 2007 were normal.  During the 27 November 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported left knee pain that limits its use and the knee gives out sometimes.  Physical examination showed lateral femoral condyle tenderness (outer end of the thigh bone that makes up the knee) with no left knee effusion or patellar grind.  Left knee range of motion (ROM) was “full.”  

The 5 February 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of sharp-lateral (outer side) knee pain.  The CI denied any swelling or locking, but there were “intermittent catching episodes.”  Physical examination showed a normal gait.  There was no localized left knee tenderness.  Patellar (knee cap) grind and instability tests were negative, and the meniscus impairment testing was negative.  Left knee flexion was 135 degrees and extension was 0 degrees.  Painful motion was not addressed.  The examiner opined that these measurements were normal for the CI without mechanical block.  A primary care visit on 19 March 2008, 3 months before separation, noted left knee pain.  Physical examination revealed no bilateral knee swelling, tenderness or muscle weakness.  Bilateral knee ROM was “full” without elicitation of painful motion.  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 left knee condition 0%, analogously coded 5099-5003 (degenerative arthritis).  The panel agreed there was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  There was no satisfactory evidence of painful motion with functional loss, proximate to separation, to support a 10% rating (based on §4.59, §4.40 and §4.45).  There was no evidence of dislocated meniscus or loss body causing frequent locking with recurrent effusions (5258), no history of cartilage (meniscus) “removal” surgery (5259), or fracture, nonunion or malunion of the femur or tibia causing a knee impairment (5255, 5262) to support a higher rating under those codes.  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-2017-03855

AR20190011610, XXXXXXXXXXXXX 

Dear XXXXXXXXXXXX

	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-2017-03855