RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXX		CASE: PD-2017-04881 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20080830

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Rifleman, medically separated for “bilateral knee pain, right greater than left” with a disability rating of 20%.

CI CONTENTION: 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 - 20080528	VARD – 20081202	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Knee Pain, Right Greater Than Left	5014-5260	20%	Right Patella Tendonitis…	5014-5260	10%	
20080311	
			Left Patella Tendonitis…	5014-5260	10%		
Congenital Pes Planus	Cat II	Bilateral Pes Planus (Flat Feet)	5276	10%		
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 30%	
	
ANALYSIS SUMMARY:

Bilateral Knee Pain, Right Greater Than Left. According to the STR and MEB NARSUM, the CI’s bilateral knee pain condition began in 2005 after long runs and ruck marches. During 2006 and 2007 the CI underwent two separate right knee arthroscopies which included a partial lateral meniscectomy.

The 20 February 2008 orthopedic clinic examination, 6 months prior to separation, noted complaints of bilateral knee pain. Both knees revealed tenderness and full range of motion (ROM). The 11 March 2008 VA Compensation and Pension (C&P) examination, 6 months prior to separation, noted complaints of infrequent episodes of knees “locking,” as well as weakness and pain. The CI endorsed the ability to walk 1 to 3 miles. The physical examination (PE) revealed an antalgic gait and bilateral knee tenderness. X-rays showed no arthritic changes or fracture and tissues appeared normal.        The CI’s diagnosis was documented as “bilateral patella (kneecap)

tendonitis with right worse than left.” At the 10 April 2008 MEB NARSUM examination, 5 months prior to separation, the CI’s chief complaint mimicked the VA’s prior diagnosis. The PE revealed a slightly antalgic gait. Both knees were tender and measured ROM was 0-120 degrees (normal 0-140).  No joint instability was in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the bilateral knee condition at 10% for each knee (20% combined), each dual-coded 5014-5260 (osteomalacia-leg, limitation of flexion). The PEB listed the congenital pes planus (flat feet) as a Category II condition, a diagnosis related to the primary unfitting condition and not separately ratable (in accordance with VASRD §4.14, avoidance of pyramiding). The 28 May 2008 PEB cited that the Category II condition was a contributing factor and that there was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at or near separation. Utilizing the same dual code, the VA rated each knee at 10% based on the C&P examination, citing physical findings as well as painful motion. The VA also rated the bilateral pes planus condition 10%, coded 5276 (flatfoot, acquired), based on the C&P examination, citing impairment criteria.

There was no limitation of flexion or extension that supported a rating under the VASRD diagnostic codes for limitation of motion (5260 or 5261). The examinations proximate to separation did not demonstrate the presence of ligamentous instability or laxity (5257), and while there was a history of right knee dislocated meniscus or loose body it did not cause frequent locking with recurrent effusions (5258) to support a rating under the respective codes. However, there was evidence of tenderness with functional loss of both knees to support 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 not advantageous for 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 bilateral knee condition.

BOARD FINDINGS: In the matter of the bilateral 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.

2	PD-2017-04881

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 23 Sep 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.

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