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AF | PDBR | CY2012 | PD-2012-00056
Original file (PD-2012-00056.pdf) Auto-classification: Denied
RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXXXXXXXXXXXXX                                                                BRANCH OF SERVICE:  ARMY 
CASE NUMBER:  PD1200056                                                                   SEPARATION DATE:  20070529 
BOARD DATE:  20121106 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  SGT/E‐5  (88M20/Wheeled  Vehicle  Operator), 
medically  separated  for  right  knee  patellar  tendinopathy,  without  compensable  limitation  of 
motion.  The CI developed right knee pain after standing for prolonged periods of time while 
running combat security missions in Iraq.  Despite steroid electrophoresis, physical therapy (PT) 
and  non  steroidal  anti  inflammatory  drugs  (NSAIDS)  the  CI  failed  to  meet  the  physical 
requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards.  
The CI was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB).  
The MEB forwarded patellar tendonopathy of right knee on the DA Form 3947 to the Physical 
Evaluation Board (PEB).  The MEB forwarded no other conditions for PEB adjudication.  The PEB 
adjudicated the right knee patellar tendinopathy as unfitting, rated 0%, with application of the 
Veteran’s Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals, and was 
medically separated with a 0% disability rating. 
 
 
CI CONTENTION:  “The condition of my right knee is worsening and has begun affecting my left 
knee.  In a conversation with my VA doctor she informed me that having to compensate for the 
injured right knee is possibly causing the left knee to deteriorate.  The VA decided on my case 
on April 2, 2008, less than one year from the date of my separation.  The VA determined that 
my right knee should be rated at 10%.  I am currently employed as a police officer. The current 
condition of my knees limit my ability to run and get in and out of my patrol car easily.  I have 
routinely been seen by VA doctors in reference to this condition.  I have tried multiple therapy 
approaches to included braces and exercises.  There has been no improvement in my condition 
through the steps taken so far.” 
 
 
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 right knee patellar condition, found 
unfitting by the PEB, and as requested for consideration, meets the criteria prescribed in DoDI 
6040.44 for Board purview; and, is addressed below.  The other requested conditions, left hand 
neuropathy,  right  upper  arm/ulnar  neuropathy,  posttramatic  stress  disorder  (PTSD)  and 
reoccurring  folliculitis  (cysts)  on  the  inner  left  thigh,  left  knee  are  not  within  the  Board’s 
purview.  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. 
 

 

Combined:  0% 

0% X 1 / Not Service‐Connected x 1 

Combined:  30% 

* VARD 20080402 rated folliculitis affecting the left inner thigh with residual scarring (claimed as cyst inner left thigh) as 7820 at 
0% and lumbar spine disability (claimed as back condition) as “Not Service Connected, Not Incurred / Caused by Service.” 
 
 
ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding  the  significant  impairment  with  which  his  service‐incurred  condition  continues  to 
burden him.  It is a fact, however, that the Disability Evaluation System (DES) has neither the 
role  nor  the  authority  to  compensate  members  for  anticipated  future  severity  or  potential 
complications of conditions resulting in medical separation.  This role and authority is granted 
by Congress to the Department of Veterans’ Affairs.  The Board utilizes DVA evidence proximal 
to  separation  in  arriving  at  its  recommendations;  and,  DoDI  6040.44  defines  a  12‐month 
interval for special consideration to post‐separation evidence.  The Board’s authority as defined 
in DoDI 6044.40, however, resides in evaluating the fairness of DES fitness determinations and 
rating decisions for disability at the time of separation.  Post‐separation evidence therefore is 
probative only to the extent that it reasonably reflects the disability and fitness implications at 
the time of separation.   
 
Right Knee Condition.  There were two range‐of‐motion (ROM) evaluations in evidence, with 
documentation of additional ratable criteria, which the Board weighed in arriving at its rating 
recommendation; as summarized in the chart below. 
 

PT~4 Mo. Pre‐Sep 
124⁰, 126⁰, 128⁰

0⁰ 

MEB ~2 Mo. Pre‐Sep 

VA C&P ~2 Mo. Post‐Sep 

Referenced PT ROMs 

“FROM” 

Right Knee ROM 

Flexion (140⁰ Normal) 
Extension (0⁰ Normal) 

Comment 

“Reason for limitation Pain 
‘No’”; Consult noted laxity 
patella ligament (bilateral); 
tenderness to palpation 
(TTP) medial/lateral joint 
line; crepitus 

10%

Referenced PT exam; 
Lachman’s test +1 (laxity) 

Pain at full flexion; Gait wnl; 
Slight lateral patellar laxity; 
reflexes 2+ 

RATING COMPARISON:   
 

Service IPEB – Dated 20070403 
Condition 
Right Knee Patellar 
Tendinopathy… 

Code 
5024 

Rating
0% 

No additional MEB / PEB entries 

VA (2‐7 Mos. Post‐Separation) – All Effective Date 20070530

Condition

Patellofemoral Syndrome of the 
Right Knee
Ulnar Neuropathy of the Right 
Upper Extremity…
Residual of Laceration to the 
Left Hand with Scarring and 
Neuropathy 
PTSD

Code 
5257 

8516 

8516 

9411 

Rating 
10% 

Exam

20070813 

10% 

20070813 

10% 

10% 

20070813 

20080130

§4.71a Rating 

10% (PEB 0%)

10% 

 
The physical therapy (PT) examination requested 4 months prior to separation noted right knee 
patellar ligament laxity and crepitus.  The exam findings are summarized in the chart above.  
The MEB examination 2 months prior to separation noted constant right knee pain interfered 
with  walking,  sitting  standing  bending  or  climbing,  along  with  waking  the  CI  up  at  night 
periodically.  The MEB exam findings are summarized in the chart above.  The commander’s 
comments  indicated  that  the  CI’s  load  bearing  limitations  precluded  him  from  performing 
strenuous duties or deployments.  Radiographs indicated patellar tendinopathy with magnetic 
resonance imaging (MRI) consistent with patellar tendinopathy.  The orthopedic letter of intent 
for the MEB indicated “chondromalacia patella refractory top treatment and severe limitations 
to duty.”  The DD Form 2807‐1 indicated history of knee swelling and knee brace use. 
 

   2                                                           PD1200056 
 

The  VA  Compensation  &  Pension(C&P)  examination  performed  2  months  after  separation 
indicated right knee stiffness and weakness in the mornings and pain in the evenings.  The C&P 
exam findings are summarized in the chart above. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  coded  the  right  knee  condition  as  5024  Tenosynovitis  rated  0%.    The  VA  coded  the 
condition 5257 knee, other impairment, recurrent subluxation or lateral instability:  slight rated 
at 10%.  The Board must decide which exam has the higher probative value as both the MEB 
exam  and  the  VA  exam  are  equidistant  from  the  date  of  separation.    The  CI  had  well 
documented findings of laxity of the patella ligament on both the PT consult request, and C&P 
exams along with findings of a Lachman 1+ (laxity) and crepitus on the MEB exam.  All the exam 
findings  substantiated  a  10%  rating.    The  Board  conceded  painful  motion  (§4.59)  and 
considered the tenets of VASRD code §4.40 (functional loss).  The Board determined that the 
VA  rating  schema  which  focused  on  the  instability  coding  5257  best  reflected  the  CI’s  knee 
disability for ideal coding, but that the PEB code of 5024 was also acceptable and neither code 
was  more  favorable  to  the  CI.    After  due  deliberation,  considering  all  of  the  evidence  and 
mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% 
coded 5024 for the right knee patellar tendinopathy. 
 
 
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.  In the matter of the right 
knee patellar tendinopathy condition, the Board unanimously recommends a disability rating of 
10%, coded 5024 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

5024 

COMBINED 

10%
10%

Right Knee Patellar Tendinopathy 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120112, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 
 
 
 

           XXXXXXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

   3                                                           PD1200056 
 

SFMR‐RB 
 

 

 
 

 

 

 
 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency  

(TAPD‐ZB / XXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202‐3557 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  

for XXXXXXXXXXXXXXXXXX, AR20130000261 (PD201200056) 

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 
 

 

 

 

 

 

 

 

 

 

 

 

 

     XXXXXXXXXXXXXX 

     Deputy Assistant Secretary 
         (Army Review Boards) 

 

 
CF:  

(  ) DoD PDBR 

(  ) DVA 

 

   4                                                           PD1200056 
 



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