RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX 	CASE:  PD-2017-04957
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090926

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Motor Transport Operator, medically separated for “right knee limitation of motion” with a disability rating of 10%.   

CI CONTENTION:  “My knee has since gotten worse.  Constantly in pain.”  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 – 20090727	VARD - 20091214	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Knee Limitation of Motion 	5260	10%	Right Knee Chondromalacia	5260	10%	20090601	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Knee Limitation of Motion.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right knee condition began in November 2007 when his knee buckled and he fell during a ruck march.  An MRI in July 2008 revealed mild chondromalacia and a subsequent MRI in May 2009 noted slight worsening.    

At the 1 June 2009 VA Compensation and Pension (C&P) examination, 4 months before separation, the CI reported progressively worsening knee pain.  Physical examination showed a normal gait without joint swelling, effusion, tenderness or laxity.  Right knee range of motion (ROM) testing showed flexion of 90 degrees (normal 140) and extension of 0 degrees (normal) with pain.  There was no further limitation on repetitive motions.   The 10 July 2009 MEB NARSUM examination, 3 months prior to separation, noted complaints of continued knee pain despite physical therapy and rest.  Physical examination was completed by the VA.  

The panel directed attention to its rating recommendation based on the above evidence.  This case was adjudicated as part of the Pilot Disability Evaluation System. The PEB accepted the VA proposed rating of 10% for the right knee condition, coded 5260 (leg, limitation of flexion).  The VA also rated the right knee condition 10%, coded 5260), based on the C&P examination, citing painful motion of a major joint.  

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).  There was no history or evidence of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258), or history of surgery to remove a meniscus (5259) to support a rating under those codes.  There was 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).  There was therefore no VASRD §4.71a rating higher than the 10% adjudicated 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 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.    

XXXXXXXXXX

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

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.

Sincerely,					      
						      					
Enclosure