RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXX	CASE:  PD-2021-00046
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041011

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Radio and Communications Security Repairer, medically separated for “left knee pain” with a disability rating of 0%.  

CI CONTENTION: No specific contention was made.  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 - 20040831	VARD - 20050217	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Knee Pain	5099- 5003	0%	No VA Examination in Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Left Knee Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent left knee surgery in November 2003 for a torn medial meniscus.

The 16 April 2004 MEB NARSUM examination, 6 months prior to separation, noted complaints of knee stiffness as well as pain with prolonged standing and sitting.  Physical examination revealed a normal gait and effusion.  Left knee range of motion (ROM) showed flexion to 135 degrees (normal 140) and extension to 0 degrees (normal).   There was increased medial and lateral joint line tenderness and sensitivity along the medial, lateral and inferior joint lines and the anterior aspect of the tibia.  The examiner documented negative anterior/posterior drawer and patellar compression tests with no varus or valgus instability.  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 US Army Physical Disability Agency pain policy.  Panel members agreed there was no limitation of flexion or extension that supported a rating under codes 5260 or 5261.  However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45), demonstrated by the slight limitation of motion and objective evidence of knee swelling during the NARSUM examination.  Alternatively, code 5259 (cartilage, semilunar, removal of, symptomatic) provided for a 10% rating.  The panel considered other VASRD knee and analogous codes, but all were less applicable and not advantageous for 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 5099-5003.  

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.  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	
Left Knee Pain	5099-5003 	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20210418, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20210014670, XXXXXXXXX. 

Dear XXXXXXXXXX:

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.

Sincerely,