RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04878
BRANCH OF SERVICE:  army	SEPARATION DATE:  20080627

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Indirect Fire Infantryman, medically separated for “right knee injury” with a disability rating of 10%.

CI CONTENTION:  No specific contention was made.  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 - 20080612	VARD - 20080912	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Injury	5299-5003	10%	Right Knee Meniscal Tear, Post-Operative 	5262	10%	20080827	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:

Right Knee Injury.  According to the MEB narrative summary (NARSUM) and service treatment record, the CI underwent right knee surgery in September 2007, approximately 10 months before separation, for meniscal and anterior cruciate ligament repair.  During the 12 December 2007 MEB NARSUM, 3 months after surgery, the CI reported severe right knee pain.  Provocative testing revealed right knee meniscal irritation.  

The 21 April 2008 physical therapy right knee range of motion (ROM) evaluation, 2 months before separation, revealed, after repetition, flexion of 135 degrees (normal 140) and extension of 10 degrees (normal 0), with painful motion.  At the 22 April 2008 MEB NARSUM examination, the CI reported right knee pain without weakness, lack of endurance, fatigability, instability or incoordination.  Physical examination showed no significant effusion, but there was knee tenderness.  

At the 27 August 2008 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported right knee pain.  Physical examination revealed a normal gait and no evidence of abnormal weight bearing.  Right knee flexion was 140 degrees and extension was 0 degrees with painful motion.  There was no loss of motion after repetition.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right knee condition 10%, analogously coded 5099-5003 (arthritis, degenerative), citing degenerative arthritis with some loss of joint motion.  The VA also rated the right knee condition 10%, coded 5262 (tibia and fibula, impairment), based on the C&P examination, citing slight knee disability.  

There was no limitation of motion proximate to separation 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) and a history of meniscal surgery (5259) which also supported a 10% rating.  There was no 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 causing a knee impairment (5255, 5262) to support a higher rating.  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.  

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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.

Sincerely,					       

Enclosure