RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  xxxxxxxxxxxxxxxxxxxxxxx  	CASE:  PD-2017-06014
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040803

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a National Guard E4, Electrician, medically separated for “left knee pain” with a disability rating of 0%. 

CI CONTENTION:  “Should be increased, painful when walking, no lifting above shoulders, has gotten worse.”  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 - 20040309	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Knee Pain	 5099-5003	0%	No VA Examination Proximate to Separation in Evidence	
Left Shoulder AC Joint Arthrosis	Not Unfitting 		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Left Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent left knee medial meniscal debridement in August 2003.  At the 14 November 2003 orthopedic consultation, he reported that he could not run greater than a quarter mile and had pain with pivoting activities, but could walk unlimited distances.  He also experienced pain when crossing his legs.  The examiner noted a normal gait without patellofemoral crepitus, but there was popping and anteromedial joint line tenderness.  Range of motion (ROM) was from 0-135 degrees (normal 0-140), and provocative testing revealed a stable knee without signs of meniscal pathology.  During the 19 November 2003 MEB examination (recorded on DD Forms 2807-1 and 2808), 9 months prior to separation, the CI reported left knee pain, and the examiner documented mild medial joint line tenderness.  The 4 December 2003 MEB NARSUM examination noted continued complaints of left knee pain.  Physical findings showed full ROM, but with mild tenderness over the medial joint line and a positive McMurray test (for meniscal pathology).  There was no effusion or erythema, and the knee was stable.  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 “degenerative arthritis without loss of joint motion.”  While there was no compensable limitation of flexion or extension (5260 or 5261), code 5259 code (cartilage, semilunar, removal of, symptomatic) was applicable in this case, and supported a 10% rating.  Panel members considered other knee and analogous codes, but all were less applicable or not advantageous to rating.  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 condition, coded 5299-5259.  

Contended PEB Condition:  Left Shoulder Acromioclavicular (AC) Joint Arthrosis.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  Although the contended condition was implicated in the commander’s statement and failed MEB retention standards, it was only profiled U2.  The CI could perform 25 push-ups and had 170 degrees of flexion and abduction (normal 180) in both shoulders.  Although there was some evidence indicative of functional impairment impacting duty performance, it did not constitute a preponderance.  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 5299-5259 IAW VASRD §4.71a.  In the matter of the contended left shoulder 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.  

Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.  

CONDITION	VASRD CODE	PERMANENT RATING	
Left Knee Pain	5299-5259	10%	

The following documentary evidence was considered:

AR20200004636

Dear XXXXXXXXXXXXXXXXXXXXXXX:

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