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 XXXXXXXXXXXX 
	Case Number PD-2020-00132

	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 (CI) 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 CI was an active duty E4, Indirect Fire Infantryman, medically separated for “left knee and leg pain,” with a disability rating of 10%.  The PEB rated the left knee and leg condition 10%, analogously coded 5003 (arthritis, degenerative), citing evidence of painful motion.  The VA rated the left knee condition 0%, dual coded 5014-5019 (osteomalacia-bursitis), based on the Compensation and Pension (C&P) examination, citing no objective evidence of painful motion, edema, effusion, instability, weakness, redness, heat or guarding of movement. The VA additionally rated the left leg condition 10%, coded 8527 (paralysis of the internal saphenous nerve), based on the C&P examination, citing severe or complete paralysis of the internal saphenous nerve.  In determining whether the PEB’s combined adjudication was justified in lieu of separate ratings, the panel agreed that undue speculation would be required to conclude that impairment from either the left knee or left leg pain would not have unacceptably interfered with the performance of military duties.  Thus, a separate disability rating was recommended for the left knee and for the left leg.  

Upon recommending a rating for the left knee condition, although there was no limitation of flexion or extension (5260 or 5261), there was evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  Other VASRD knee and analogous codes were considered, but all were less applicable and not advantageous for rating.  Upon recommending a rating for the left leg condition, it was noted that the CI experienced overall improvement in leg pain after surgery to remove the saphenous nerve; however, he reported continued numbness in areas around the surgical scar.  There was no muscle damage, atrophy, or weakness, and he was able to run, walk, bike and swim at his own pace and distance, with no severe functional impairment demonstrated.  Thus, a 0% rating under code 8527 was warranted for mild to moderate disability from the nerve removal.   Other VASRD leg and analogous codes were considered, but all were less applicable and not advantageous for rating.  Because separate leg and knee disability ratings resulted in the same overall combined rating, no change to the PEB adjudication is recommended.  

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 and leg pain conditions.  

AR20210005018

Dear XXXXXXXXXXXXXXXXXX:

	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.

A copy of this decision has been provided to the counsel you listed on your application