RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-04463 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20090130

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

CI CONTENTION: “I have had three additional surgeries on the left knee.” In addition, the CI 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 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 - 20081022	VARD - 20090225	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Chronic Knee Pain likely associated with Iliotibial Band Friction Syndrome	5314	10%	S/P Left Knee Surgery X2 with Residual Degenerative Joint Disease	5003	10%	20081015	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Left Knee Pain. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent left knee arthroscopic surgery in September 2007 for a small posterior horn lateral meniscus tear. A subsequent left knee surgery was performed in March 2008 for iliotibial band release.

The 28 August 2008 MEB NARSUM examination, 6 months prior to separation, noted complaints of lateral-sided left knee pain. Physical examination showed the left knee had well-healed incisions. He was tender along the anterior edge of the iliotibial band. There was no swelling.  He had full range of motion (ROM) and was stable to varus and valgus stress testing. He had a negative Lachman’s, negative pivot shift, negative McMurray test and negative patellofemoral compression test. X-rays of the left knee were unremarkable. During the 8 September 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported left knee pain.  Physical examination revealed left knee lateral tenderness.

At the 15 October 2008 VA Compensation and Pension (C&P) examination, 3 months before separation, the CI reported constant left knee pain associated with weakness, swelling, giving way, fatigability, and lack of endurance. The pain was brought on by physical activities and improved with rest and pain medication. Physical examination showed the CI walked with a normal gait. Left knee ROM showed flexion of 120 degrees (normal 140) and extension of 0 degrees (normal) after repetition. Painful motion was noted. There was no evidence of ligament instability and Drawer sign and McMurray tests were both negative.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left knee condition 10%, coded 5314 (Group XIV. Function of the pelvic girdle and thigh). The VA also rated the left knee condition 10%, coded 5003 (degenerative arthritis), based on the C&P examination, citing evidence of painful motion of the left knee with limited motion in flexion with lack of endurance following repetitive use. There was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261). However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §§4.59, 4.40 and 4.45). There was 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 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.

The following documentary evidence was considered:

2	PD-2017-04463

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 

IN   REPLY   REFER  TO :
1850
CORB: 003 20May20

From: 

Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL DISABILITY  BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBRltrdtd 17Nov 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate  action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation  Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.