SAF/MRBD (PDBR)
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MEMORANDUM FOR THE DIRECTOR, AIR FORCE REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on Case Number PD-2021-00079

	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 Air Force.  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 E5, Integrated Avionics Systems Craftsman, medically separated for “right thigh pain” and “left knee impairment,” rated 10% each, with a combined disability rating of 20%.  

The PEB rated the right leg condition 10%, coded 5255 (femur impairment).  The VA rated the right leg condition 20%, analogously coded 5299-5255, based on the Compensation and Pension (C&P) examination, citing moderate knee or hip disability.  The MEB narrative summary (NARSUM) and C&P examinations did not show any ratable right leg limitation of motion or decrease in muscle strength or tone.  Although the CI had a slight limp, there was no disturbance of gait or stance, and no use any assistive device for ambulation.  While intermittent pain reportedly interfered with daily activities, it was not severe enough to significantly impair any activity of daily living, and was improved by medication and rest.  Thus, the next higher 20% rating for moderate knee or hip disability was not warranted.  Other VASRD leg and analogous codes were considered, but all were less applicable and not advantageous for rating. There was therefore no higher rating than the 10% adjudicated by the PEB.

The PEB rated the left knee condition 10%, coded 5257 (knee impairment), citing laxity causing no more than slight knee impairment.  The VA rated the left knee condition 20%, also coded 5257, based on the C&P examination, citing moderate recurrent subluxation/lateral instability of the knee.  The MEB NARSUM examination showed a normal gait and no collateral or cruciate ligament laxity.  While a re-examination statement 4 months before separation recorded moderate instability, clinical findings and the functional impairment did not show knee locking, giving way, loss of balance or recurrent subluxation.  Of note, during the NARSUM and C&P examinations, the CI did not report any symptoms reflective of an unstable knee and functional knee instability was not documented.  There was no evidence of knee instability severe enough to prevent most normal daily functions to warrant a rating higher than the 10% adjudicated by the PEB.  Additionally, there was no compensable limitation of motion that resulted in a higher rating.

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 leg or left knee condition.    

SAF/MRB
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		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2021-00079.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no rating modification or re-characterization of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.