RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04485
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070607

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, OH-58D Armament/Electronic/Avionics Systems Repairer, medically separated for “patellofemoral syndrome right knee” with a disability rating of 0%.

CI CONTENTION:  The right knee condition continues to worsen and negatively affects daily activities.  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’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 - 20070510	VARD - 20071204	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Patellofemoral Syndrome	5099-5003	0%	Right Knee Patellofemoral Syndrome	5299-5260	0%	20071108	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Right Knee Patellofemoral Syndrome.  According to the service treatment record and MEB narrative summary (NARSUM), the CI had a history of right knee pain starting at age 11.  He subsequently experienced right knee pain during basic training but was able to successfully perform his military duties.  An MRI in 2006 revealed mild patellar chondromalacia and mild thickened medial plica.  The 10 April 2007 MEB NARSUM examination, 2 months prior to separation, noted complaints of right knee pain with daily flare-ups.  Physical examination showed right knee patellar tenderness, but provocative testing for instability or meniscal pathology were negative.  Range of motion (ROM) was full; painful motion was not addressed.  

The MEB physical therapy (PT) ROM examination, 1 month before separation, showed right knee flexion to approximately 124 degrees (normal 140) and extension was approximately 4 degrees of hyperextension (normal 0); painful motion was not addressed.  

At the 8 November 2007 VA Compensation and Pension (C&P) general examination, 5 months after separation, the CI reported progressively worsening right knee pain.  Physical examination showed a normal gait, and no right knee swelling, tenderness or laxity.  Right lower extremity muscle strength was 5/5.  The ROM evaluation showed flexion of 135 degrees and extension of 0 degrees; painful motion was absent.  Right knee X-rays were negative.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 0%, analogously coded 5099-5003 (arthritis, degenerative), citing no ratable limitation of motion.  The VA also rated the right knee condition 0%, 5299-5260 (leg, limitation of flexion), based on the C&P general examination, citing a non-compensable examination.  The panel agreed there was no evidence of limitation of motion (5260, 5261), history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258), history of meniscal surgery (5259) or fracture, nonunion or malunion of the femur or tibia causing a knee impairment (5255, 5262) to support a 10% rating under those codes.  No additional functional limitation based on §4.59, §4.40 and §4.45 was evidenced by the examinations.  Therefore the panel concluded there was insufficient evidence to support a rating higher than the 0% 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 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:

AR20190007298, XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

	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.