RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXX	CASE: PD-2017-04304
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060908

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was a National Guard E7, Combat Engineer, medically separated for “chronic bilateral knee pain and stiffness,” each knee rated 10%, with a combined disability rating of 20%.

CI CONTENTION:  “My knee conditions worsening.” 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 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 – 20060601	VARD - 20070305	
Condition	Code	Rating	Condition	Code	Rating	Exam	

Chronic Bilateral Knee Pain	
5003	10%	Chronic Knee Pain, Osteoarthritis Right Knee	5260-5003	10%	
20060630	
		10%	Chronic Knee Pain, Osteoarthritis Left Knee	5260-5003	10%		
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 50%	

ANALYSIS SUMMARY:

Chronic Bilateral Knee Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI injured his left knee in February 2001 when it became struck between two vehicles, and in December 2005, he hyperextended his right knee when stumbling. Knee X- rays reportedly showed mild right knee and moderate left knee degenerative joint disease (DJD).

The 29 December 2005 physical therapy progress note, 8 months prior to separation, documented a gait with a normal stride length, and no effusion or edema. Right knee flexion was to 125 degrees (normal 140) and extension to 0 degrees (normal). Left knee flexion was to 135 degrees and lacked 5 degrees of extension. The 20 April 2006 MEB NARSUM examination, 5 months before separation, noted CI complaints of bilateral knee pain. Physical examination showed no knee inflammation, but there was diffuse non-specific bilateral tenderness and crepitus. Measured range of motion (ROM) of both knees revealed flexion of 130 degrees and extension of 0 degrees; painful motion was not addressed.

At the 30 June 2006 VA Compensation and Pension (C&P) examination, 2 months prior to separation, the CI reported daily bilateral knee pain, left greater than right. The left knee pain was rated at 8/10, and the right knee pain at 7/10, with flares to 9/10 precipitated by walking several miles. Physical examination noted crepitus bilaterally, but no tenderness. Right knee flexion was to 120 degrees (with pain from 115-130 degrees) and extension to 0 degrees. Left knee flexion was to 120 degrees (with pain from 110-120 degrees) and extension of 0 degrees. There was no change in motion of either knee after repetition. The panel directed attention to its rating recommendation based on the above evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated each knee condition 10%, coded 5003 (arthritis, degenerative), citing radiographic evidence of DJD and loss of motion. The VA also rated the each knee condition 10%, but analogously coded 5260-5003 (leg, limitation of flexion-arthritis degenerative) based on the C&P examination, citing painful or limited motion of a major joint. Panel member 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). The panel considered other VASRD knee and analogous codes, but all were less applicable and/or not advantageous for rating. There was therefore no higher rating than the 10% adjudicated by the PEB. 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 bilateral knee condition.

BOARD FINDINGS: In the matter of the bilateral 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-2017-04304

AR20200000171, XXXXXXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXXXXX

	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-2017-04304