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 Case Number PD-2018-00361
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 Marine Corps. 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, Bulk Fuel Specialist, medically separated for “hypertrophic osteoarthropathy [bilateral knee and ankle]” with a disability rating of 20%. The PEB
adjudicated the condition as exisiting prior to service (EPTS), with a 0% reduction, and analogously coded 5099-5009 (arthritis, other types). The VA rated the hypertrophic osteoarthropathy condition 10%, coded 5003 (degenerative arthritis), based on the service treatment record, citing in-service X-ray evidence of arthritis in multiple major joints due to the finding of non-inflammatory arthritis of the knees and ankles. The panel agreed a 20% rating was supported coded 5099-5002 (analogous to rheumatoid arthritis) for one or two exacerbations a year in a well-established diagnosis. The panel alternatively considered if a higher rating was supported under 5002 based on residuals of the knee and ankle joints. There was no limitation of motion which attained a 10% rating under the diagnostic codes for limitation of flexion or extension of the knees (5260, 5261) or moderate limitation of ankle motion (5271). There was no fracture, nonunion or malunion of the femur or tibia to support consideration under the respective codes for knee impairment related to long bone conditions (5255, 5262). Additionally, there was also no evidence of painful, limited motion of either knee or ankle to support individual 10% ratings coded 5009 or analogous to 5003.
However, a single 10% rating was supported for all joints combined based on imaging evidence of arthritis of two or more major joints coded 5003 or 5009, but this provided no ratings benefit to the CI. Consequently, there was no rating higher than a 20% supported under any applicable VASRD 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 hypertrophic arthropathy condition.

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-S023

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
1.	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 ofno 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.