DEPARTMENT OF THE AIR FORCE
WASHINGTON DC

Office of the Assistant Secretary

SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

MEMORANDUM FOR THE ASSISTANT SECRETARY OF THE NAVY, MANPOWER
AND RESERVE AFFAIRS

SUBJECT: Physical Disability Board of Review Recommendation on XXXXXXXXXX Case Number PD-2017-05858

In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual from the United States Navy. After carefully reviewing the application and medical separation case file, the PDBR recommended no re-characterization of the separation or modification of the disability rating previously assigned. I recommend you accept this proposed decision.

The covered individual (CI) was an active duty E4, Gas Turbine Mechanical Maintenance Technician, medically separated for “right patellofemoral syndrome” and “left patellofemoral syndrome,” rated 10% each, with a combined disability rating of 20%. The PEB adjudicated the right knee condition as existing prior to service (EPTS) with a 0% EPTS deduction, coded 5099-5003 (degenerative arthritis). The PEB also adjudicated right knee anterior cruciate ligament (ACL) repair prior to service entry and status post (S/P) microfracture right knee for chondromalacia patella as Category II conditions which contributed to the primary unfitting condition but were not separately ratable. The two Category II diagnoses were intertwined with the Category I condition, and the overall knee impairment from all listed right knee diagnoses was properly subsumed under a single rating by both the PEB and the VA, IAW
§4.14 (avoidance of pyramiding). The VA rated the right knee condition 0%, dual coded 5260- 5024 (leg, limitation of flexion - tenosynovitis), based on the C&P examination, citing that physical examination demonstrated normal range of motion (ROM) of the right knee, without pain, even after repetitive use.

A 10% rating was supported when coded as 5257 for slight knee disability due to subluxation or lateral instability. A higher rating for moderate knee disability was not warranted based on a normal gait and the absence of swelling. There was no limitation of motion which supported a rating under the diagnostic codes for limitation of flexion or extension (5260, 5261). There was no objective evidence of limited motion (such as swelling, muscle spasm, crepitus, painful motion) documented at the MEB NARSUM or VA examinations to support an additional 10% rating under 5003. Although the panel’s rating recommendation relies on a different code than that of the PEB, it provides no ratings benefit to the CI and therefore no change to the PEB’s code is recommended. 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.

The PEB also adjudicated the S/P left ACL reconstruction as a Category II condition and like the right knee, this diagnosis was intertwined with the Category I diagnosis, and the overall impairment from both listed left knee diagnoses was subsumed under a single rating by both the PEB and the VA. The VA rated the left knee condition 0%, dual coded 5260-5024, based on the C&P examination, citing the VA physical examination demonstrated normal left knee ROM. Other VASRD knee and analogous codes, were less applicable and/or not advantageous for rating. There was no evidence to support a rating for the left knee higher than that adjudicated by the PEB. 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.

2	PD-2017-05858

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE 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 Sep 20

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

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
I.	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.