RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-04484 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20090730

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Rifleman, medically separated for “right knee plica status post [s/p] resection with continued pain” with a disability rating of 10%.

CI CONTENTION: “The issue was caused while overseas in a combat zone. It hinders everyday activity. The pain can be unbearable at times. It has caused issues in other parts of the body.” 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 - 20090521	VARD - 20090929	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Plica S/P Resection with Continued Pain	5099-
5003	10%	Right Knee Patellofemoral Syndrome, S/P Arthroscopic Surgery	5024-5260	10%	20090603	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Right Knee Plica S/P Resection with Continued Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right knee surgery in April 2008 for excision of plica. A 13 March 2009 MEB NARSUM examination, 5 months prior to separation, noted complaints of daily pain from 4-7/10 with strenuous activity worsening the pain to an 8/10. The pain was on the inside and was sharp, stabbing and punching. Physical examination showed a non-antalgic gait. There was tenderness with no effusion, instability, or patellar apprehension. There was a positive patella compression test and medial patella pain with an increased Q-angle. There was “full range of motion [ROM].” The quadriceps were weak due to pain.

The 29 September VARD summarized a 3 June 2009 pre-separation VA Compensation and Pension (C&P) examination, where the CI reported right knee weakness, stiffness, swelling, and

giving way. Physical examination (not in evidence) was reported to show crepitus and a positive compression test of the right knee. ROM was normal during extension, but limited to 130 degrees during flexion, with pain. Following repetitive use, there was pain, fatigue, weakness, and lack of endurance, but this did not change ROM. Ligament, menisci, and stability tests were normal.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right knee condition 10%, analogously coded as 5003 (degenerative arthritis). The VA also rated the right knee condition 10%, analogously coded 5024-5260 (tenosynovitis - limitation of flexion) based on the C&P examination, citing pain during ROM testing and a functionally impaired knee 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). The panel considered other VASRD knee and analogous codes, but all were less applicable and/or not advantageous for rating. 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 plica status post resection with continued pain 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-2017-04484

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) PDBR ltr <ltd 17 Nov 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 of no 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.