RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXX CASE: PD1200879 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130313 

SEPARATION DATE: 20030131 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (92G/Food Service Specialist) medically 
separated for chronic left knee pain. The CI injured his left knee in March 2001 during a 
company run. He underwent arthroscopic surgery in September 2001. Despite continued 
treatment his left knee could not be adequately rehabilitated to meet the physical 
requirements of his Military Occupational Specialty (MOS). His profile allowed for an alternate 
aerobic event (walk) to satisfy physical fitness standards. He was issued a permanent L3 profile 
and referred for a Medical Evaluation Board (MEB). Untreated hypertension and mild scoliosis, 
identified in the rating chart below, were also identified and forwarded by the MEB. The 
Informal Physical Evaluation Board (IPEB) adjudicated the left knee condition as unfitting, rated 
10%, with application of the US Army Physical Disability Agency (USAPDA) pain policy. The 
remaining conditions were determined to be not unfitting. The CI made no appeals, and was 
medically separated with a 10% disability rating. 

 

 

CI CONTENTION: “At the time of separation from the Army I was given 10% due to my left knee 
condition. The surgery was perform in the military and they told me that my knee problem was 
fix. Well that’s not the case my left knee has gotten worst since that operation and now it stops 
me from taken care of my family. I became a truck driver and has lost employment, because I 
couldn’t do my job correct. My last employer sent a letter to the VA telling them because of my 
knee problem which cause me to stop to much and it was unsafe because my left knee would 
swell that there were time where it was hard for me to press the clutch to stop. I am talking 
about a 18 wheel that truly un-safe. ” 

 

 

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, 
paragraph 5.e. (2). It is limited to those conditions determined by the PEB to be unfitting for 
continued military service and those conditions identified but not determined to be unfitting by 
the PEB when specifically requested by the CI. The rating for the unfitting left knee condition is 
addressed below; and no additional conditions are within the DoDI 6040.44 defined purview of 
the board. 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. IAW DoDI 6040.44, the Board’s authority is limited to 
making recommendations on correcting disability determinations. The Board’s role is thus 
confined to the review of medical records and all evidence at hand to assess the fairness of PEB 
rating determinations, compared to Veteran’s Affairs Schedule for Rating Disabilities (VASRD) 
standards, based on ratable severity at the time of separation. The Board acknowledges the 
CI’s information regarding the significant impairment with which his service-connected 
condition continues to burden him; but, must emphasize that the Disability Evaluation System 
has neither the role nor the authority to compensate members for anticipated future severity 
or potential complications of conditions resulting in medical separation. That role and 
authority is granted by Congress to the Department of Veteran Affairs, operating under a 
different set of laws. 

 

 


RATING COMPARISON: 

 

Service IPEB – Dated 20021202 

VA (38 Mos. Post-Separation) – All Effective Date 20051128 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Left Knee Pain 

5099-5003 

10% 

Left knee, s/p arthroscopy 

5299-5259 

10% 

20060414 

Untreated hypertension 

Not Unfitting 

Hypertension 

7101 

0% 

STR 

Mild Scoliosis 

Not Unfitting 

No VA Entry for Scoliosis 

 

 

 

.No Additional MEB/PEB Entries. 

0% X 1 

20060414 

Combined: 10% 

Combined: 10% 



 

 

 

ANALYSIS SUMMARY: 

 

Left Knee Pain. In March 2001, the CI fell and struck his left knee on a rock. Ever since then, he 
has had problems with left knee pain. Many different treatment options were tried for his knee 
pain including: medication, physical therapy (PT), and arthroscopic surgery. However, in spite 
of treatment, the left knee pain persisted. He was seen by Orthopedics on 1 October 2002. On 
examination there was no effusion, and he flexed his left knee to 140 degrees (with pain). 
Lachman’s drawer test and valgus stress were all negative. The examiner noted diffuse 
tenderness to palpation (TTP) “out of proportion.” The CI’s MEB clinical evaluation was at Fort 
Stewart in November 2002. Examination showed moderate TTP over the anteromedial aspect 
of the knee, most significant above the joint line. The patellar grind test was positive. Once 
again the CI flexed his left knee (with discomfort) to 140 degrees. There was no redness or 
swelling, and the knee was not grossly unstable. Lachman’s, drawer, and pivot shift tests were 
all negative. 

 

Three years after separation, the CI had a VA Compensation and Pension (C&P) exam. He 
reported left knee pain, especially after prolonged walking or prolonged driving. However, he 
was able to perform all normal activities without impairment. On exam, his posture and gait 
were normal. The left knee appeared normal; without redness, swelling, deformity or 
instability. There was some pain on motion, beyond 110 degrees flexion. He was on no 
medications for pain. The three goniometric ROM evaluations which the Board reviewed are 
summarized in the chart below. 

 

Left Knee ROM 

Ortho – 4 mos. Pre-Sep 

(20021001) 

MEB – 3 mos. Pre-Sep 

(20021108) 

C&P – 38 mos. Post-Sep 

(20060414) 

Flexion (140° is Normal) 

140° 

140° 

120° 

Extension (0° is Normal) 

0° 

0° 

0° 

Comment 

Pain with motion 

Pain with motion 

Painful motion 

§4.71a Rating 

10%* 

10%* 

10%* 



*10% based on VASRD §4.40 (Functional loss), §4.45 (The joints), and §4.59 (Painful motion) 

 

The Board carefully examined all evidentiary information available. After consideration of the 
three clinical evaluations noted above, the Board determined that the October 2002 Ortho 
exam and the November 2002 MEB exam had greater probative value since they were 
conducted just a few months prior to separation. The C&P exam was done 38 months after 
separation. The Board can use VA 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. Post-separation evidence is probative only to the extent that it 
reasonably reflects the disability and fitness implications at separation. The Board determined 
that 38 months was too long. Therefore, due to its low probative value, the clinical data from 
the April 2006 C&P exam was weighed less heavily by the Board in arriving at its rating 
recommendation. In matters germane to the severity of the knee condition at the time of 


separation, the information in the service treatment record (STR) was given proportionately 
more probative value as a basis for the Board’s rating recommendation. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB and the VA chose different coding options for the knee condition, but both assigned a 
rating of 10%. The CI’s left knee condition was essentially non-compensable based on the 
VASRD §4.71a codes for loss of knee motion (5260 and 5261). However; IAW VASRD §4.40, 
§4.45, and §4.59, a 10% rating is warranted when there is satisfactory evidence of functional 
limitation due to painful motion of a major joint. The Board tried to find a path to a rating 
higher than 10%, using other codes which could be applied to the left knee condition. The 
other VASRD codes that were considered did not result in a rating higher than 10%, since the 
STR did not show evidence of a significantly disabling joint abnormality which would justify a 
rating higher than 10%. 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 left knee pain 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. In the matter of the left 
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 

Chronic Left Knee Pain, Status Post Arthroscopic Surgery 

5099-5003 

10% 

RATING 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20130122, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

xxxxxxxxxxxxxxxxxxxxxxx, DAF 

Acting Director 

Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxx, AR20130007517 (PD201200879) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)