RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX 	CASE:  PD-2017-05660
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060504

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Automated Logistical Specialist, medically separated from the Temporary Disability Retired List (TDRL) for “chronic left knee pain” with a disability rating of 0%.   

CI CONTENTION:  His medical conditions continue to hamper his quality of life.  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’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 - 20060421	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Knee Pain…	5261	0%	No VA Examination Proximate to TDRL Removal in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Left Knee Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent multiple surgeries on his left knee secondary to a prior injury he sustained while playing football.  He was initially separated and placed on the TDRL on 15 September 2004.  At the 6 August 2004 TDRL evaluation, 2 weeks prior to final separation, the CI endorsed continued left knee pain worsened by bending, squatting, prolonged ambulation, and all impact activities.  Physical examination revealed an antalgic gait favoring the left leg.  The left knee had no swelling, fluid buildup, or discoloration.  Range of motion (ROM) was recorded as 5-140 degrees (normal 0-140) and was painful.  Clinical testing for ligamentous or meniscal damage resulting in joint instability was negative.  There was no VA examination proximate to TDRL removal in evidence. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left knee pain at 10%, coded 5261 (limitation of leg extension).  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), as recorded at the TDRL evaluation.  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).  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the left knee pain, coded 5003.  

BOARD FINDINGS:  In the matter of the chronic left knee pain, the panel recommends a disability rating of 10%, coded 5003 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Left Knee Pain	5003	10%	

PD-2017-05660

, XXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXXXXXX

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs. 

PD-2017-05660