RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200762 SEPARATION DATE: 20030509 

BOARD DATE: 20121114 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-5 (95B10, Military Policeman), medically 
separated for chronic right knee pain status post arthroscopic surgery. He sustained a twisting 
injury to the right knee during duty in 2000 and was evaluated by orthopedic surgery. He 
underwent right knee arthroscopy and was able to continue in his Military Occupational 
Specialty (MOS) with a P2 profile but later had increasing activity related pain and activity 
related swelling in the right knee that was unresponsive to physical therapy, activity 
modification, injections (Synvisc), nonsteroidal anti-inflammatory medications, and profiling. 
The CI was unable to meet the physical requirements of his MOS, was issued a permanent L3 
profile and referred for a Medical Evaluation Board (MEB). The MEB forwarded no other 
conditions for Physical Evaluation Board (PEB) adjudication. The PEB adjudicated the chronic 
right knee pain status post arthroscopic surgery due to chronic chondral defects to the medial 
femoral condyle and medial patellar facet condition as unfitting, rated 0%, citing the US Army 
Physical Disability Agency (USAPDA) pain policy. 

 

 

CI CONTENTION: “My knee continuously locks up, gives out, swells and makes it difficult to 
work and/or walk at times.” 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in 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 ratings 
for unfitting conditions will be reviewed in all cases. The chronic right knee pain status post 
arthroscopic surgery condition as requested for consideration meets the criteria prescribed in 
DoDI 6040.44 for Board purview; and is addressed below. Any conditions or contention not 
requested in this application, or otherwise outside the Board’s defined scope of review, remain 
eligible for future consideration by the Army Board for the Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service PEB – Dated 20030228 

VA (4 Mos. Pre-Separation) – All Effective Date 20030510 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Right Knee Pain 
Status Post Arthroscopic 
Surgery 

5099-5003 

0% 

Right Knee Pain Status Post 
Arthroscopic Surgery for Chronic 
Chondral Defects 

5299-5259 

10% 

20030109 

No Additional MEB/PEB Entries 

Not Service-Connected x 1 

20030110 

Combined: 0% 

Combined: 10% 



 

 


ANALYSIS SUMMARY: 

 

Right Knee Condition. The goniometric and other range-of-motion (ROM) evaluations in 
evidence which the Board weighed in arriving at its rating recommendation, with 
documentation of additional ratable criteria, are summarized in the chart below. 

 

Right Knee ROM 

(Degrees) 

MEB ~ 4 Mo. Pre-Sep 

VA C&P ~ 4 Mo. Pre-Sep 

Flexion (140 Normal) 

“FROM” 

135 

Extension (0 Normal) 

0 

Comment 

Trace effusion; tender; neg. 
multiple stability tests; neg 
McMurray’s and squat signs 
(see text) 

Gait normal; ROM limited by pain; 
normal drawer test; McMurray’s 
abnormal; no evidence of effusion; 
repetitive motion testing specified 

§4.71a Rating 

10% (PEB 0%) 

10% 



 

At the MEB exam, the CI reported chronic right knee pain. The CI’s right knee arthroscopy was 
described as a microfracture technique performed to the medial femoral condyle, as well as 
chondroplasty performed on the medial patellar facet. The MEB physical exam noted 
tenderness, a trace effusion and no signs of instability. The DD Form 2808 exam from a month 
prior to the narrative summary (NARSUM) indicated a tender right knee with limited ROM, 
cannot squat and positive crepitation. Treatment notes indicated post-surgical occasions of 
“popping” and history of give way without complaints of locking. Some exams indicated 
positive crepitus, grinding, and positive McMurray’s sign with some exams also negative for 
those findings. 

 

At the VA Compensation and Pension (C&P) exam performed prior to separation, the CI 
reported continued pain occurring with walking, prolonged standing, climbing, or attempts at 
running. “He can complete normal tasks at a very slow and easy pace with constant resting, but 
is not able to engage in the above activities.” Three Synvisc injections had provided only 
temporary relief. The exam is summarized above with pain-limited motion with a positive 
meniscal sign (McMurray’s). Sensory and motor exams were normal. Radiograph showed 
osteochondral defect with postoperative changes medial femoral condyle. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB coding was IAW the USAPDA pain policy as 5099-5003 and the VA coding was analogous to 
5259 (cartilage, semilunar, removal of, symptomatic) at 10%. The NARSUM exam indicated 
trace effusion with normal ROM without specifying repetition, pain or other DeLuca factors. 
The VA exam indicated pain limited ROM “additionally limited by pain, fatigue, weakness and 
lack of endurance, but not by incoordination” without specified ROM decrement on repetition. 
Treatment notes indicated episodes of swelling and crepitus. The Board considered VASRD 
§4.59 (painful motion), §4.40 (functional loss) and §4.45 (the joints) and adjudged the VA exam 
had the highest probative value for rating at separation. There was no evidence of 
incapacitating periods or sufficient objective evidence of “locking” proximate to separation to 
justify coding under 5258 for “frequent episodes of “locking,” pain, and effusion into the joint.” 

 

After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable 
doubt), the Board recommends a disability rating of 10% for the right knee condition coded 
analogously as 5099-5003. 

 

 

 

 


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. As discussed above, PEB 
reliance on the USAPDA pain policy for rating right knee condition was operant in this case and 
the condition was adjudicated independently of that policy by the Board. In the matter of the 
right knee condition, the Board unanimously recommends a disability rating of 10%, coded 
5099-5003 IAW VASRD §4.71a. There were no other conditions within the Board’s scope of 
review for consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of his prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Chronic Right Knee Pain Status Post Arthroscopic Surgery 

5099-5003 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120602, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxx, DAF 

 President 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxxxxxxxxx, AR20130004941 (PD201200762) 

 

 

1. 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 to modify the individual’s disability rating to 10% without recharacterization 
of the individual’s separation. This decision is final. 

 

2. I direct that all the Department of the Army records of the individual concerned be corrected 
accordingly no later than 120 days from the date of this memorandum. 

 

3. I request that a copy of the corrections and any related correspondence be provided to the 
individual concerned, counsel (if any), any Members of Congress who have shown interest, and 
to the Army Review Boards Agency with a copy of this memorandum without enclosures. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)