RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX	CASE:  PD-2017-04230
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051209

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Cavalry Scout, medically separated for “[right] valgus knee injury with a disability rating of 10%.  

CI CONTENTION:  Review 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 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 - 20051117	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Valgus Right Knee Injury	5099-5003	10%	No VA Examination Proximate to Separation	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Right Knee Injury.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent an ACL reconstruction on 2 February 2005, and at an orthopedics visit on 16 September 2005, 3 months prior to separation, he reported chronic pain along the medial aspect of the right knee.  He was unable to run, squat or perform his military specialty duties.  The provider noted tenderness along the medial aspect of the right knee, but no varus or valgus instability.  The range of motion (ROM) was 0-145 degrees (normal 0-140).  

The 4 November 2005 MEB NARSUM, 1 month before separation, noted increasing right anteromedial knee pain and giving way after returning to physical training with his unit.   He also had tingling and irritation on the lateral aspect of the knee.  He was unable to run, but could walk for approximately 30 minutes and stand for about 30-45 minutes before he had significant pain.  Physical examination revealed tenderness along the borders of the patellar tendon, but full right knee ROM, and no varus or valgus instability.  Pivot shift, Lachman’s and McMurray’s test were negative.  There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing functional limitation caused by pain.  Panel members agreed that while there was no compensable limitation of flexion or extension (5260 or 5261), there was evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  Alternatively, persistent pain after meniscal surgery also warranted a 10% rating under code 5259 (cartilage, semilunar, removal of symptomatic).  The panel considered other VASRD knee and analogous codes, but all were less applicable and/or not advantageous for rating.  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 right knee condition. 

BOARD FINDINGS:  In the matter of the right 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.  

The following documentary evidence was considered:

PD-2017-04230

AR20200000659, XXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXX

	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-2017-04230