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

MEMORANDUM FOR THE DIRECTOR, ARMY REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on XXXXXXXX
	Case Number PD-2017-05985

	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 Army.  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 E3, Trainee, medically separated for “chronic right knee pain” with a disability rating of 10%.  The PEB coded the knee condition 5299-5262 (analogous to tibial and fibula, impairment), citing the applicable “slight” criterion for contiguous knee disability.  Code 5262 confers higher ratings of 20% for “moderate” and 30% for “marked” knee disability.  The VA, based on the Compensation and Pension (C&P) examination, conferred two associated ratings: 10% under code 5299-5260 (analogous to limitation of flexion) citing slight limitation of motion with pain, and 0% under the above PEB code citing failure to satisfy the minimum slight criterion.  The panel considered multiple VASRD knee and analogous codes, but these were less applicable and/or not advantageous for rating. The panel considered a higher rating for knee disability under code 5299-5262 (above), but members agreed that the functional impairment in evidence at separation (normal gait and mobility, only more strenuous activities affected, resolving pathology) did not support the next higher rating for moderate disability.  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.  

In the matter of the contended left tibial plateau stress fracture and bilateral mid-shaft tibial stress reactions, the preceding stress fractures/reactions were assessed as medically unacceptable by the MEB, and bilateral diagnoses were listed on the L3 profile.  The commander’s performance statement was nonspecific with regard to specific fitness implications for either extremity.  That notwithstanding, the narrative summary, corroborated by service treatment record provider entries, documented the absence of any significant clinical acuity for the left knee, and healing of the stress fractures/reactions, by the time of separation.  Any residual functional implications due to these conditions with regard to the right knee would have been subsumed with the above rating.  Panel members agreed that there was not a preponderance of performance-based evidence to indicate that any residual functional implications with regard to the left knee would have 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 either of these contended conditions, so no additional disability ratings are recommended.  

	

AR20200004629, XXXXXXXXXXXX

Dear XXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.