RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXX  	CASE:  PD-2017-05929
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20061206

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Non-destructive Inspection Journeyman, medically separated for “patellofemoral syndrome, left knee,” with a disability rating of 10%.  

CI CONTENTION:  “Review all conditions.”  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 – 20061023	VARD – NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Patellofemoral Syndrome, Left Knee	5099-5003	10%	No VA examination proximate to separation in evidence.	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA 	

ANALYSIS SUMMARY:  

Left Knee Patellofemoral Syndrome.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the injured her left knee in October 2005.  Imaging (MRI) was normal except for some mild bone edema (all ligaments and menisci intact).  Provider entries in the STR documented grossly normal range of motion (ROM), a normal gait, and no effusion, instability or impingement (locking).

The 8 September 2006 MEB NARSUM examination, 3 months prior to separation, documented nonspecific left knee pain without subjective locking or instability that was exacerbated by running, walking, heavy lifting and prolonged standing.  The physical examination recorded tenderness, but the CI had a normal gait, and no effusion, instability or impingement.  The examiner noted full ROM, as corroborated by multiple other service examiners, although there were no formal ROM measurements in evidence.  There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left knee condition 10%, coded 5299-5003 (analogous to degenerative arthritis).  There was no limitation of motion which supported a minimum 10% rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  Panel members considered other knee and analogous codes, but all were less applicable or not advantageous to rating.  There were no other criteria in evidence to support a rating higher than 10% under any applicable VASRD §4.71a 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.  

SAF/MRB

Dear XXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05929.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no rating modification or re-characterization of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.