RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXx	CASE:  PD-2017-05950
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070111

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty O3, Infantry Officer, medically separated for “chronic left knee pain” with a disability rating of 0%. 

CI CONTENTION:  He contended for his unfitting left knee condition, obstructive lung disease and 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 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 – 20061004	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Knee Pain	5099-5003	0%	No VA Examination Proximate to Separation in Evidence	
Respiratory Allergies	Not Unfitting		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Left Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left knee condition began in early 2001.  X-rays done in April 2002 were normal; however, an MRI also done in April 2002 showed a small signal abnormality at the anterior horn of the lateral meniscus, but the radiologist reported that it was more likely a normal signal versus a meniscal tear.  On 21 July 2003 the CI underwent a diagnostic left knee arthroscopy and iliotibial band release.  

During the 14 June 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 7 months prior to separation, the CI reported continued left knee pain that had failed conservative therapy.  Physical examination showed tenderness along the left knee lateral patellofemoral area and over the left lateral joint line.  There was a negative McMurray’s test (to determine a meniscal tear) and no laxity.  There was a questionable positive retropatellar grind test and tenderness over the iliotibial track and over the greater trochanter of the left hip.  Increased pain was present with left knee extension and left hip flexion.  The same-day MEB NARSUM examination noted continued left knee pain that he rated at 5/10, which worsened to 10/10 with prolonged weight-bearing and impact activities.  He had no improvement with rest, PT or other medical modalities, but was able to perform activities of daily living.  No further surgery was recommended.  Physical examination referenced the information from the MEB examination (above).  X-rays of the left knee dated10 July 2006 were normal and PT-measured range of motion (ROM) the following day were 125 degrees flexion (normal 140) with 0 degrees extension (normal).  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 0%, analogously coded 5099-5003 (degenerative arthritis), citing the U.S. Army Physical Disability Agency pain policy and rated for constant and minimal pain.  The panel considered multiple VASRD knee and analogous codes, but these were less applicable and/or not advantageous for rating, however, the panel majority noted there was evidence of painful motion of the left knee with extension with functional loss to support a 10% rating (based on VASRD §§4.59, 4.40 and 4.45).  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel majority recommends a disability rating of 10% for the left knee condition, coded 5099-5003.  

Contended PEB Condition:  Respiratory Allergies.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement, and did not fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the left knee condition, the panel recommends a disability rating of 10%, coded 5099-5003 IAW VASRD §4.71a.  The single voter for dissent recommends no change and did not elect to submit a minority opinion.  In the matter of the contended respiratory allergy condition, the panel recommends no change from the PEB determination as not unfitting.  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	5099-5003	10%	

The following documentary evidence was considered:

AR20200004373

Dear XXXXXXXXXXXXXXXXXXXXXX:

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