RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200926 SEPARATION DATE: 20070216 

BOARD DATE: 20130226 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty PV2/E-2 (91W/Medical Specialist), medically 
separated for chronic right knee pain status post (s/p) arthroscopy for lateral meniscus tear. 
CI’s pain began during an AGR run and doing fireman’s carry in the field. CI had a magnetic 
resonance imaging (MRI) exam that showed a torn meniscus on the right knee in November 
2006. The chronic right knee pain condition could not be adequately rehabilitated. The CI did 
not improve adequately with treatment to meet the physical requirements of his Military 
Occupational Specialty (MOS) or satisfy physical fitness standards. He was issued a permanent 
L3 profile and referred for a Medical Evaluation Board (MEB). Adjustment disorder condition, 
identified in the rating chart below, was also identified and forwarded by the MEB. The 
Physical Evaluation Board (PEB) adjudicated the right knee condition as unfitting, rated 10%, 
citing criteria of the US Army Physical Disability Agency (USAPDA) pain policy. The CI made no 
appeals, and was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: “I feel that my conditions were just as severe when I was medically 
discharged as they are now. If I am already rated at 70% through VA that leads me to believe 
my rating from the Army should be much higher. I originally filed for VA compensation with a 
few days after separating from Army. However they did not act on original filing. So I had to 
re-file using DAV help and it was eventually acknowledged that my original filing date was well 
within 12 months of my separation date. I have since appealed their original decision and 
submitted additional documentation & proof of severity of injuries & ailments and thus have 
been awarded 70% rating which I feel is a more accurate rating. Based on current claims.” 

 

 

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 unfitting chronic right knee pain 
condition meets the criteria for Board purview and is addressed below. The additional 
condition of adjustment disorder was also forwarded on the DA Form 3947; however, it is not a 
ratable condition IAW DoDI 1332.38 Enclosure 5.1.3.9 and will not be discussed further. 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 
Correction of Military Records. 

 


RATING COMPARISON: 

 

Service IPEB – Dated 20070206 

VA (17 Mos. Post-Separation) – All Effective Date 20090526 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Right Knee Pain 
Status Post Arthroscopy 
for lateral Meniscus Tear 

5099-5003 

10% 

Right Meniscus Tear, Status Post 
Arthroscopy (claimed as right 
knee lateral meniscus) 

5260 

*10% 

20090728 

Adjustment Disorder 

Not a physical 
disability 

Adjustment Disorder with 
Depression 

9434 

*0% 

20090729 

.No Additional MEB/PEB Entries. 

Not Service-Connected x 1 

 

Combined: 10% 

Combined: *10% 



* R. knee, 5260 with temporary 100% ratings in 2009 and 2010; 9434 increased to 70% effective 20111005 (combined 70%) 

 

 

ANALYSIS SUMMARY 

 

Chronic Right Knee Pain Condition. The narrative summary (NARSUM) notes the CI had 
arthroscopic knee surgery about 3 months prior to separation due to pain and instability of the 
right knee following an injury with meniscus tear. An MRI of the right knee was done prior to 
surgery and showed a right knee lateral meniscus tear. Service treatment records (STRs) show 
many medical treatment visits for bilateral knee pain diagnosed as patellofemoral pain 
syndrome (PFPS) prior to the diagnosis of the right lateral meniscal tear and multiple temporary 
profiles for one or both knees. The CI was made aware that the surgery was for the lateral 
meniscal pain and would not help the patellofemoral pain. The goniometric range-of-motion 
(ROM) evaluations in evidence, with documentation of additional ratable criteria, which the 
Board weighed in arriving at its rating recommendation are as summarized in the chart below. 

 

Right Knee ROM 

MEB ~2 Mo. Pre-Sep 

VA C&P ~17 Mo. Post-Sep 

Flexion (140° Normal) 

135° 

130° 

Extension (0° Normal) 

0° 

0° 

Comment: 

Surgery 3 Mo. Pre-Sep, & 

6 & 22 Mo. Post-Sep 

Normal strength and 
sensation; no laxity; positive 
quad atrophy (see text) 

Slight limp; brace; painful 
motion; tenderness; normal 
strength; no instability (see text) 

§4.71a Rating 

10%-20% (PEB 10%) 

10%-20% (VA 10%) 



 

At the MEB exam it was noted that post-operatively (within a month) the CI continued to have 
knee pain that prevented him from taking any primary or alternate Army Physical Fitness Test 
(APFT). The MEB exam showed knee ROM noted in the table above. He had a positive grind 
with no apprehension, no patellar tilt or laxity. Motor and sensory were intact. There was no 
crepitus or swelling. There was a negative Lachman’s; “negative drawers;” negative 
McMurray’s; and no laxity with varus or valgus stressing. He did have quadriceps atrophy on 
the right and tenderness to palpation of the lateral collateral ligament. The narrative summary 
(NARSUM) stated the “MEB physical was 2 November 2006.” Surgery was 29 November 2006. 
The physical exam stated “The soldier is *ambulating with crutches at this time and *wearing a 
stabilizing brace on his right knee. He has obvious quad atrophy noted with girth on the right 
measuring 40.8 and on the left measuring 42.4. He has a positive grind with no apprehension, 
no patellar tilt or laxity” which was typed with the asterisked areas having hand-written “not” 
inserted over the typed text. The record documented that in addition to the knee surgery 3 
months prior to separation, the CI underwent additional right knee arthroscopic surgery with 
partial lateral menisectomy and lateral knee cyst excision 6 months after separation. 

 

At the VA Compensation and Pension (C&P) exam performed about 17 months after separation, 
the CI reported weakness, stiffness, swelling, giving way, lack of endurance, locking, fatigability, 
tenderness, pain and dislocation of the right knee. He reported flare-ups, 10 times per where 
his knee “pops out of place and can’t move.” He rated the severity level 10. He reported 
difficulty with standing and walking; but his condition had not resulted in any incapacity. He 
reported that he might have to quit his job because he “can’t sit for long periods and no 
standing, brace required.” The VA exam showed three scars on the right knee that were not 


painful, disfiguring and did not restrict motion. There was no swelling, instability, locking pain, 
or crepitus of the right knee. ROM was as noted in the table above and was additionally limited 
by pain after repetitive use. The examiner listed pain and decreased motion as the residuals of 
the CI’s right knee lateral meniscus tear and the effect on his occupation was moderate due to 
pain; the effect on his daily activity was none. Records documented that the CI had continued 
“catching in the knee” and underwent additional right knee arthroscopic surgery 22 months 
post-separation with partial lateral menisectomy. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the right knee condition as 5099-5003 at 10% and cited the USAPDA Pain policy. The 
VA rated 5260 (limited leg flexion) at 10%. The Board noted that the MEB was accomplished 
within a month following knee surgery and the PEB noted and referenced obvious quadriceps 
muscle atrophy. The CI had additional symptoms from a knee cyst and meniscal tear within 6 
months following separation. By the 17 month remote VA exam, the atrophy had resolved, 
however, meniscal symptoms persisted. Although the VA exam did not document objective 
meniscal signs, the CI underwent meniscal surgery repair within 5 months after that exam. 
Given the MEB-noted quadriceps atrophy, continued knee symptoms of meniscal pathology; 
and second meniscal repair within 6 months of separation, the Board considered the CI’s 
disability picture at the time of separation was closest to the disability picture portrayed by 
analogous coding as 5258 (Cartilage, semilunar, dislocated, with frequent episodes of “locking,” 
pain, and effusion into the joint) at 20%. After due deliberation, considering all of the evidence 
and mindful of VASRD §4.3 (reasonable doubt) and §4.7 (higher of two evaluations), the Board 
recommends a disability rating of 20% for the right 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. As discussed above, PEB 
reliance on the USAPDA pain policy for rating the 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 chronic right knee pain condition, the Board unanimously recommends a disability rating of 
20%, coded 5099-5258 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 

5099-5258 

20% 

COMBINED 

20% 



 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120619, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 


 

SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxxxx, AR20130006058 (PD201200926) 

 

 

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 20% 
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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)