RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:XXXXXXXXXXXXXX	CASE:  PD-2017	-0527	4
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20070831
SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Assistant Gunner, medically separated for “early osteoarthritis of the left knee” with a disability rating of 10%.
CI CONTENTION: The 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 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 - 20070831	VARD - 20080325	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Early Osteoarthritis of the Left Knee	5299-5003	10%	
Left Knee Patellofemoral Pain Syndrome	
5014	
NSC	
20071219	
Status Post [S/P] Left Knee
Microfracture	Cat II					
Severe Chondromalacia of Left Knee	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Left Knee Osteoarthritis. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent left knee surgery in March 2007 with no surgical findings of abnormal meniscal pathology. Post-operative left knee range of motion (ROM) revealed flexion to 90 degrees (normal 140) and extension to 5 degrees (normal 0). At the 4 June 2007 MEB NARSUM examination, 3 months prior to separation, the examiner noted persistent left knee pain worsened by heavy impact activities. Physical examination revealed a slight joint effusion with mild tenderness, but no instability, and full knee ROM.

During the 19 December 2007 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI made no new complaints. Physical findings noted swelling and an abnormal gait that required the assistance of a cane. During ROM tests, the CI could “extend the left knee

out 15 degrees” and “only lift and flex…approximately 40 degrees.” The examiner noted he could not extend or flex the left lower extremity against resistance due to pain and instability.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left knee condition 10%, analogously coded 5299-5003 (degenerative arthritis), and listed “s/p left knee arthroscopy with microfracture” and “severe chondromalacia of left knee” as Category II conditions (contribute to the primary condition but not separately ratable). Panel members noted these related diagnoses were part and parcel of the unfitting left knee condition and were properly subsumed under that condition to avoid pyramiding (VASRD §4.14). The VA also rated the left knee condition 10%, coded 5014 (osteomalacia), based on the C&P examination, citing painful or limited motion of a major joint. Although the post-separation VA ROM examination showed severe limitation of both flexion and extension, such parameters were inconsistent with other historical (post-surgical) ROM measurements proximate to separation. Therefore, the panel awarded a higher probative value to the pre-separation examinations which showed evidence of painful motion with a maximum rating of 10%. Additionally, the panel considered other VASRD knee and analogous coding schemes, but all were less applicable and/or not advantageous to rating. There was therefore no higher rating than the 10% adjudicated by the PEB available under any applicable VASRD 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 left knee condition.

BOARD FINDINGS: In the matter of the left 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:

2	PD-2017-05274

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO:
1850
CORB: 003
10 Sep20

From: Director, Secretary of the Navy Council of Review Boards To:

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 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.