RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201355 SEPARATION DATE: 20060818 

BOARD DATE: 20130312 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (31B20/Military Police), medically separated 
for right knee pain. The right knee condition could not be adequately rehabilitated 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). The MEB forwarded “chronic knee pain with intermittent locking, tri-compartment 
degenerative joint disease, right knee condition” and no other conditions for Physical 
Evaluation Board (PEB) adjudication. The PEB adjudicated the right knee pain condition as 
unfitting, rated 10%, with application of the Veteran’s Affairs Schedule for Rating Disabilities 
(VASRD). The CI made no appeals, and was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: “I suffer from constant pain in my knee and have been told I will need a knee 
replacement but VA won't replace it until I am at least 55….I had 3 orthoscopic knee surgeries 
while on Active Duty and have since had another orthoscopic surgery done at the VA hospital to 
clean up the cartilage and bone and remove broken pieces of bone.” The CI also contends for 
service disability compensation for his ankles, hips, shoulder, neck, eye surgery, PTSD, blood 
clots, sleep apnea, nose, and hearing loss. 

 

 

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 the unfitting right knee condition will be reviewed. The other requested conditions (right 
ankle pain, hip pain, blood clots, PTSD, sleep apnea, right eye cataract surgery, shoulder pain, 
discs in the neck, nose bleeds, and hearing problems) 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. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20060523 

VA (~5 Mos. Post-Separation) – All Effective Date 20060819 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Right Knee Pain 

5257 

10% 

DJD, Right Knee, Post Operative 

5010-5260 

10% 

20070111 

.No Additional MEB/PEB Entries. 

PTSD 

9411 

30% 

20070111 

Degenerative Changes, Lumbar Spine 

5242 

10% 

20070111 

 0% X 1 / Not Service-Connected x 6 

Combined: 10% 

Combined: 40%* 



Based on VARD proximate to separation 20070214. Additional condition (ankle sprain added @10%) by VARD 20100223 
effective 20060819. 

 

 


ANALYSIS SUMMARY: The Disability Evaluation System (DES) is responsible for maintaining a fit 
and vital fighting force. While the DES considers all of the member's medical conditions, 
compensation can only be offered for those medical conditions that cut short a service 
member’s career, and then only to the degree of severity present at the time of final 
disposition. The DES has neither the role nor the authority to compensate members for 
anticipated future severity or potential complications of conditions resulting in medical 
separation nor for conditions determined to be service-connected by the Department of 
Veterans Affairs (DVA) but not determined to be unfitting by the PEB. However the DVA, 
operating under a different set of laws (Title 38, United States Code), is empowered to 
compensate all service-connected conditions and to periodically re-evaluate said conditions for 
the purpose of adjusting the Veteran’s disability rating should the degree of impairment vary 
over time. The Board’s role is confined to the review of medical records and all evidence at 
hand to assess the fairness of PEB rating determinations, compared to VASRD standards, based 
on severity at the time of separation. 

 

Right Knee Pain Condition. There were three goniometric 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. 

 

Right Knee ROM 

(Degrees) 

PT ~5 Mos. Pre-Sep 

(20060314) 

MEB ~5 Mos. Pre-Sep 

(20060329) 

VA C&P ~5 Mos. Post-Sep 

(20070111) 

Flexion (140 Normal) 

121 

90-95 

76 

Extension (0 Normal) 

7 

15 

8 

Comment 

Flexion limited by pain 

Fell on knee morning of exam 

15 degrees loss of extension 

1+ Lachman (unchanged from 
entrance examination) 

Slight antalgic gait. 

Pain at end point of flexion 

8 degrees loss of extension 

No instability 

Gait normal. 

§4.71a Rating 

10% 

20% 

10% 



 

The MEB narrative summary (NARSUM) notes that the CI underwent an anterior cruciate 
ligament (ACL) reconstruction on his right knee in 1988, 4 years prior to entry into the military. 
At the time of enlistment medical examination, an orthopedic evaluation 17 June 1992 
concluded the left knee ACL was deficient showing mild instability on examination with a 1+ 
Lachman, and positive pivot shift. The CI received medical clearance for entry into military 
service and entered active duty in September 1992. He reinjured the right knee in 1994 playing 
sports and underwent arthroscopic surgery in February 1995 and October 1996. Recurrent 
knee symptoms led to another arthroscopic surgery in February 2000 with findings of 
degenerative changes (chondromalacia) involving the medial and lateral femoral condyles, 
retropatellar surface, and the medial tibial plateau. A radial tear of the lateral meniscus was 
noted and was debrided. He did well post-operatively and was able to continue in his job. His 
MOS was changed to 31B (MP). The CI did well until a deployment to Iraq (deployed March 
2004 to March 2005) when he underwent multiple episodes of intermittent locking beginning in 
November 2004 which inhibited his function as an active duty soldier. He returned with his unit 
from deployment and was subsequently evaluated by orthopedics. A torn meniscus was 
suspected. Magnetic resonance imaging (MRI) scan on 9 August 2005 showed degenerative 
changes but no meniscus tear. There was no clear visualization of the ACL and a tear could not 
be excluded. Follow up in physical therapy 24 August 2005 noted the history of right knee 
locking. On examination there was no instability, extension was normal, and flexion 110 
degrees. At the time of a 20 October 2005 clinic examination, ROM was “full”, with patellar 
crepitus. There was no instability (negative Lachman, anterior drawer), and the McMurray test 
was negative for meniscus signs. The gait was normal and no tenderness was observed on 
ambulation. An MRI scan performed on 2 March 2006, showed degenerative changes with 
intact posterior cruciate ligament and collateral ligaments. The ACL could not be “demarcated” 


and the radiologist suspected a rupture of the previous repair. There was a “suspicion of a 
subtle tear” of the lateral meniscus, but no full tears or dislocated meniscus was noted. 
Physical therapy MEB ROM examination of the right knee on 14 March 2006 is recorded in the 
chart. At the MEB NARSUM examination 28 February 2006, the CI reported difficulty with 
prolonged standing, difficulty mounting and dismounting military tactical vehicles secondary to 
pain at the right knee. The pain was present approximately 10% of the time and depended 
upon activities. He was able to perform the aerobic portion of the fitness test with a walk or 
cycle and had accomplished this successfully for several years. On examination there was a 
slight antalgic gait secondary to a recent fall upon the right knee and apparent locking 
phenomena at the time of the examination. The right knee showed some slight swelling, and 
there was limitation of motion as recorded in the chart. There was a positive apprehension test 
and positive patellar grinding. There was a positive Lachman’s sign. The NARSUM does not 
specify the Lachman grade but the DA Form 199 cites the Lachman as 1+. There were well-
healed scars from his prior knee surgeries. There was slight atrophy of the right quadriceps but 
muscle strength was normal (tested at 5/5). X-rays showed degenerative changes in the three 
compartments of the right knee. At the 11 January 2007 VA Compensation and Pension (C&P) 
examination, performed 5 months after separation, the CI reported he was employed full time 
as a correctional officer. He was able to perform his activities of daily living without difficulty. 
His right knee was associated with stiffness, swelling, instability, giving away, locking, and 
weakness. He had flares of symptoms 2-3 times a week that lasted about 3 hours. ROM is 
documented in the chart. There were complaints of pain with extremes of ROM testing. There 
was no evidence of meniscus tear, joint laxity, crepitus, and no neurological deficits. Gait was 
normal. X-ray impression was severe osteoarthritic changes. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
limitation of motion in flexion and extension from the physical therapy and C&P examinations 
did not attain a minimum compensable level, supported by the normal gait at the time of the 
C&P examination. The limitation of extension at the time of the MEB NARSUM examination 
was related to a fall the morning of the examination and was not reflective of the overall 
limitation of motion documented in the treatment records. The Board noted the PEB rated the 
knee condition using the code for knee instability (5257). The Board noted the MRI findings 
showing evidence of a deficient ACL and MEB NARSUM examination with a positive Lachman 
test graded 1+. However the pre-enlistment orthopedic examination also documented a 1+ 
Lachman test consistent with a deficient ACL indicating the existing prior to service mild 
instability had not worsened during service. There were no symptoms of instability recorded in 
the MEB examination. In addition, the C&P examiner (January 2007) did not find instability at 
the time of that examination. The Board also noted a C&P examination form May 2009 which 
did not find instability. Therefore the Board did not conclude rating under the 5257 code 
selected by the PEB was appropriate. There were intermittent symptoms of locking however 
MRI scanning did not show a dislocated meniscus to warrant rating under the respective code. 
The symptoms were consistent with the extensive post traumatic degenerative arthritis of the 
knee. The Board noted the presence of degenerative arthritis and functional limitations and 
agreed a 10% rating (§4.40) was supported by the evidence. 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 rating adjudication for the right 
knee condition but concluded the rating was best coded as 5010-5003. 

 

 

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. In the matter of the right 
knee pain/degenerative joint disease condition, the Board unanimously recommends a 


disability rating of 10%, coded 5010-5003 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 

Right Knee Pain / Degenerative Joint Disease 

5010-5003 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120722, 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 / xxxxxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxx, AR20130006288 (PD201201355) 

 

 

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 description without modification of the 
combined rating or 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 xxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)