[AR Number], XXXXXXXXXX

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XXXXXXXXXX
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Dear XXXXXXXXXX:

	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.

			      
Enclosure

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX. 	CASE:  PD-2017-04737
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050427

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Indirect Fire Infantryman, medically separated for “right knee complex medial meniscus tear” and “left knee complex medial meniscus tear” rated 10% each, with a combined disability rating of 20%. 

CI CONTENTION:  Review requested of left and right knees and obsessive-compulsive disorder (OCD).  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 -  20050414	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Complex Medial Meniscus Tear	5259	10%	No VA Examination Proximate to Separation	
Left Knee Complex Medial Meniscus Tear	5259	10%		
Obsessive Compulsive Disorder	Not Unfitting		
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Right Knee Complex Medial Meniscus Tear.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent right knee arthroscopic surgery in June 2001 for a partial removal of a torn medial meniscus.  Right knee pain returned in August 2002, and he had a second arthroscopy in August 2003 for additional removal of torn medial meniscus.  

During the 4 January 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI reported chronic knee pain, and the examiner noted he was unable to squat due to pain.  The 3 March 2005 MEB NARSUM examination, 2 months before separation, recorded complaints of constant knee pain that became sharp and increased with activity.  Physical examination showed flexion to 135 degrees (normal 140) and extension to 0 degrees (normal), with crepitus.  There was no VA examination proximate to separation in evidence.  

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 of, symptomatic), citing full range of motion (ROM) with chronic pain on motion.  Members agreed there was no limitation of flexion or extension which supported a ratings under diagnostic codes 5260 or 5261.  However, there was a history of partial removal of the semilunar cartilage with continued symptoms to support a 10% rating under code 5259.  There was no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258), and no fracture, nonunion or malunion of the femur or tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262).  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.  

Left Knee Complex Medial Meniscus Tear.  According to the STR and MEB NARSUM, onset of the CI’s left knee pain began in August 2002.  Symptoms significantly progressed and he underwent an arthroscopy in February 2004 which demonstrated a complex posterior horn medial meniscus tear which was debrided.  During the MEB examination, the CI reported chronic knee pain and the examiner documented that he was unable to squat due to pain.  The MEB NARSUM examination noted complaints of constant knee pain that became sharp and increased with activity.  Physical examination showed flexion to 135 degrees and extension to 0 degrees, with crepitus.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left knee condition 10%, coded 5259, citing full ROM and no joint instability, but residuals of chronic pain on motion.  Members agreed there was no limitation of flexion or extension which supported a ratings under diagnostic codes 5260 or 5261.  However, there was a history of partial removal of the semilunar cartilage with continued symptoms to support a 10% rating (5259).  There was no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258), and no fracture, nonunion or malunion of the femur or tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262).  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.  

Contended PEB Condition:  OCD.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement, and did not fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the right knee condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the left knee condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended obsessive compulsive disorder, the panel recommends no change from the PEB determination as not unfitting.  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: