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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