RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04350
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20051016

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Food Service Specialist, medically separated for “right knee pain” with a disability rating of 10%.

CI CONTENTION:  In addition to the right knee condition, the CI also requested review 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’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 - 20050908	VARD - 20060418	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Knee Pain	5259	10%	Right Knee Osteoarthritis 	5010-5260	10%	20051201	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:

Chronic Right Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent a diagnostic right knee arthroscopy in April 2005 with microfracture of osteochondritis dissecans (OCD) and removal of multiple loose bodies.  Post-surgical X-rays revealed small OCD.  The 31 May 2005 orthopedic consultation examination showed no appreciable right knee effusion and good patellar mobility.  Right knee extension to flexion was 0 to 135 degrees (normal 0 to 140); painful motion was present.  Provocative testing for meniscal pathology was negative.  The 29 July 2005 MEB NARSUM examination, 3 months prior to separation, noted complaints of right knee pain located under and around the kneecap.  Physical examination showed no right knee effusion and good patellar mobility.  Range of motion was “full” with pain in extreme flexion.  There was also right knee tenderness and popping.  Testing for meniscal pathology was negative.

At the 1 December 2005 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported constant right knee pain and intermittent swelling.  Physical examination showed a normal gait, but there was right knee effusion and crepitus.  Repetitive flexion was 110 degrees and extension was 0 degrees; painful motion was present.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 10%, coded 5259 (cartilage, semilunar, removal, symptomatic), citing full motion and good stability with degenerative joint disease, joint line tenderness and popping.  The VA also rated the right knee condition 10%, dual coded 5010-5260 (traumatic arthritis causing limitation of left flexion), based on the C&P examination, citing limitation of flexion.

The panel agreed there was no compensable limitation of motion (5260, 5261), no evidence of meniscal surgery (5259), no evidence of dislocated meniscus or loss body causing frequent locking with recurrent effusions (5258), nor fracture, nonunion or malunion of the femur or tibia causing a knee impairment (5255, 5262) to support a rating under those codes.  However, there was evidence of painful motion with functional loss to support a 10% rating (based on §4.59, §4.40 and §4.45).  There was therefore no VASRD §4.71a rating higher than the 10% adjudicated by the PEB under any applicable code.  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:

AR20190004415, XXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXX:

	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.

A copy of this decision has been provided to the counsel you listed on your application, XXXXXXXXXXXXXXXXXXXX.