Author: JOHN J. D'ORAZIO
Last saved by: BARKSDALE, JAMEILL M GS7 USAF SAF SAF/MRBE
Company: Pre-installed Company

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  	CASE:  PD1201511
BRANCH OF SERVICE:  Army	BOARD DATE:  20130329
SEPARATION DATE:  20020620

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (37F20/Psychological Operations Specialist) medically separated for a bilateral knee condition.  The CI injured his knees during a parachute jump early in training.  He continued to suffer knee pain throughout completion of his training and the rest of his service career.  He was diagnosed with bilateral chondromalacia patellae; and, in 2000, his symptoms steadily escalated.  He did not respond adequately to treatment to meet the physical requirements of his MOS or satisfy physical fitness standards.  He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB).  The MEB forwarded the condition (bilateral chondromalcia patellae diagnosis) to the Informal Physical Evaluation Board (IPEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The IPEB adjudicated “bilateral chronic knee pain” as a single unfitting condition, rated 20% (10% each knee with bilateral factor (BF) included), IAW the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI withdrew an initial appeal for a Formal PEB (FPEB); and, was medically separated with a 20% disability rating.

CI CONTENTION:  “I believe my rating is inaccurate because all of service connected injuries (i.e. Bilateral pes planus and plantar fasciitis (also claimed as right plantar fasciitis ), left post healed fibula fracture, concussion with residual of migraine - type headaches, and lumbosacral stain were not assessed.  My physical rating was based solely on right and left patellofemoral pain syndrome with osteoarthritis.

SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in Department of Defense Instruction (DoDI) 6040.44 (Enclosure 3, paragraph 5.e.2) is limited to those conditions which were determined by the PEB to be specifically unfitting for continued military service; or, when requested by the CI, those condition(s) “identified but not determined to be unfitting by the PEB.”  The rating for the unfitting knee condition(s) is addressed below.  The requested bilateral foot, left leg, migraine and lumbar conditions were not identified by the PEB, and thus are not within the DoDI 6040.44 defined purview of the Board.  Those, and any other conditions or contention not requested in this application, remain eligible for future consideration by the respective Service Board for Correction of Military Records.

RATING COMPARISON:  

Service PEB – Dated 20011221 | VA - (~2 Mos. Pre-Separation)
Condition | Code | Rating | Condition | Code | Rating | Exam

Bilateral Knee Pain/Chondromalacia Patellae
(10% R + 10% L w/BLF)

5099-5003

20%

Right Patellofemoral Pain Syndrome wth Osteoarthritis (Originally Claimed as Chronic Bil  Knee Condition)

5099-5003

10%

20020430

| | | Left Patellofemoral Pain Syndrome with Osteoarthritis and Status Post Healed Fibula Fracture (Originally Claimed as Bilateral Knee Condition) | 5099-5003 | 10% | 20020430
No Additional MEB/PEB Entries | Other x 7 | 20020430
Combined:  20% | Combined:  40%
VARD 20020625 (most proximate to date of separation [DOS]) 

ANALYSIS SUMMARY:

Bilateral Chronic Knee Condition.  The record indicates that the CI had pain in both knees that limited MOS performance.  The CI was treated conservatively with minimal benefit.  Orthopedic examination, 19 March 2001, revealed tenderness to palpation, no effusion, and a normal range-of-motion (ROM) in the left knee with slight reduction in the right knee (125 degrees).  It was determined that he was not a surgical candidate.  X-rays of both knees, in December 2000, showed degenerative changes with mild irregularity of the posterior patellar surface.  Bone scan on 3 January 2001 was normal.  The MEB examination 28 November 2001, approximately 7 months prior to separation, documented no instability, effusion and near normal full ROM.  The VA Compensation and Pension (C&P) examination, 30 April 2002, approximately 7 weeks prior to separation, the CI reported daily pain in both knees.  The physical examination documented no instability and noted right flexion of 135 degrees and left of 140 degrees, not affected by pain, weakness, lack of endurance or incoordination.  The PEB combined bilateral knee pain as a single unfitting condition coded analogously to 5003 and rated 20%.  The Board noted the bilateral knee condition was combined, not bundled, and were given separate rating of 10% based on pain.  The VA used the same code and rated each knee at 10%.  The Board considered codes 5260, and 5258; however, since there was no evidence of knee locking, effusions, instability or decreased ROM, the Board unanimously agreed there were no other rating considerations.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the bilateral chronic knee condition.

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.  In the matter of the bilateral chronic knee pain condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:  

UNFITTING CONDITION | VASRD CODE | RATING
Bilateral Chronic Knee Pain | 5099-5003 | 20%
COMBINED | 20%

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20120812, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

	Physical Disability Board of Review

SFMR-RB									

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(TAPD-ZB), 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for AR20130009585 (PD201201511)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a,   I accept the Board’s recommendation and hereby deny the individual’s application.  
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:

Encl						
						         (Army Review Boards)

CF: 
(  ) DoD PDBR
(  ) DVA

PD1201511