RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXX	CASE: PD-2017-03986
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060805

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Motor Transport Operator, medically separated for “osteoarthritis left knee” 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 - 20060428	VARD - 20070911	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Osteoarthritis Left Knee	5003	0%	Degenerative Joint Disease of the Left Knee	5260	10%	20070716	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Left Knee Osteoarthritis. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent an anterior cruciate ligament (ACL) reconstruction with a chondroplasty and partial medial meniscectomy in April 2005.

The 16 March 2006 MEB NARSUM examination, 5 months prior to separation, noted complaints of continued left knee pain, rated at 3-10 in severity (depending upon activities), and aggravated by prolonged walking, getting in and out of trucks, exercise, or stairs. Physical examination showed a normal gait and stance, with range of motion (ROM) recorded as 0-125 (normal 0-140),

and limited by pain. The examiner documented crepitus, but normal knee cap mobility, and negative Lachman’s testing for ligamentous laxity.  Neurologic findings were normal.

At the 16 July 2007 VA Compensation and Pension (C&P) examination, 11 months after separation, the CI reported constant left knee pain that could increase to 10/10 in severity with physical activity. Physical examination showed a normal gait, posture, and neurological findings. The examiner recorded ROM from 0-105 degrees with both locking pain and pain-limited motion, as well as “major” left knee pain after repetitive motion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left knee condition 0%, coded 5003 (degenerative arthritis), citing “…without compensable limitation of motion.” The VA rated the left knee condition 10%, coded 5260 (limitation of leg flexion), based on the C&P examination, citing “loss of motion, due to pain, at 0-105 degrees.” 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 to warranted 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, analogously coded 5099-5003.

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

2	PD-2017-03986

AR20190012009, XXXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

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-2017-03986