RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:   NAVY  
SEPARATION DATE:  20020803 

 
NAME:    
CASE NUMBER:  PD1200407 
BOARD DATE:  20121114 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered 
individual  (CI)  was  an  active  duty  Petty  Officer  Second  Class/E-5  (9545/Law 
Enforcement Specialist), medically separated for chondromalacia patellae of the left knee and 
advanced  impingement  with  partial-thickness  rotator  cuff  tear  of  the  left  shoulder.    The  left 
knee condition began in 1999 and the left shoulder condition began in 2001; neither condition 
was a consequence of injury.  Despite two knee surgeries and conservative treatment for both 
conditions, the CI did not improve adequately to meet the physical requirements of his rating or 
satisfy physical fitness standards.  He was placed on limited duty [LIMDU] and referred for a 
Medical  Evaluation  Board  (MEB).    The  MEB  forwarded  chondromalacia  patellae,  left  knee, 
advanced impingement, left shoulder and partial thickness rotator cuff tear, left shoulder to the 
Physical Evaluation Board (PEB) as medically unacceptable IAW SECNAVINST 1850.4E.  No other 
conditions  appeared  on  the  MEB’s  submission.    The  PEB  adjudicated  the  chondromalacia 
patellae of the left knee and advanced impingement with partial-thickness rotator cuff tear of 
the left shoulder conditions as unfitting, rated 10% and 0% respectively, 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:  “REQUESTING TO CHANGE STATUS FROM MEDICAL SEPERATION TO 
RETIREMENT ON ON THE PERMANENT DISABILITY LIST.”  [sic] 
 
 
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 left knee and left shoulder conditions 
as requested for consideration meet the criteria prescribed in DoDI 6040.44 for Board purview; 
and, are addressed below.  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 Board for Correction of Naval Records. 
 
 
RATING COMPARISON: 
 

Service IPEB – Dated 20020522 

Code 

5299-5003 

Rating 
10% 

Chondromalacia of the 
Patella, Left Knee 

VA (~1.5 Mos. Post-Separation) – All Effective Date 20020804 
Exam 

Condition 

Code 

5099-5014 

Rating 
10% 

20020918 

5301 

0% 

Impingement Syndrome, Left 
Shoulder 

5299-5203 

10%* 

20020918 

Condition 

Chondromalacia Patellae of 
the Left Knee 
Advanced Impingement 
with Partial-Thickness 
Rotator Cuff Tear of the 
Left Shoulder 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

 Not Service-Connected x 2 
Combined:  20% 

20020918 

*VA decision 20110119 increased to 20% based on later exam, code changed to 5299-5201, effective 20100325; combined 30% 

ANALYSIS  SUMMARY:    The  Board  notes  the  current  VA  ratings  listed  by  the  CI  for  all  of  his 
service-connected conditions, but must emphasize that its recommendations are premised on 
severity at the time of separation.  The VA ratings which it considers in that regard are those 
rendered most proximate to separation.  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 Veterans’ Affairs. 
 
Left  Knee  Condition.    Progressively  worsening  knee  pain  with  no  prior  trauma  led  to  an 
arthroscopy on 12 April 1999 which established the diagnosis of chondromalacia patellae.  Due 
to  ongoing  pain,  magnetic  resonance  imaging  (MRI)  performed  in  September  2000  re-
confirmed that diagnosis and revealed no other abnormalities.  On 22 January 2001, a lateral 
patellar release surgery was performed in an attempt to alleviate persistent pain.  There were 
three  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. 
 

Left Knee ROM 

Flexion (140⁰ Normal) 
Extension (0⁰ Normal) 

Comment 

§4.71a Rating 

PT ~5.5 Mo. Pre-Sep 

PT ~4 Mo. Pre-Sep 

VA C&P ~1.5 Mo. Post-Sep 

125⁰ 
5⁰ 

+ Tenderness, swelling 

10% 

140⁰ 
0⁰ 

Non-tender 

10%* 

“Full Active Motion” 

+ Tenderness 

10% 

      *Conceding pain with use 
 
The  narrative  summary  (NARSUM)  examiner  reported  that  the  CI  continued  to  experience 
difficulty  with  knee  swelling  from  minimal  activity.    He  was  unable  to  run  short  distances 
without significant pain, and experienced difficulty climbing and descending stairs.  Examination 
noted  painful  motion  and  a  positive  grind  with  crepitance,  but  no  joint  line  tenderness.  
Ligament  stability  testing  was  normal.    X-rays  were  normal.    At  the  VA  Compensation  and 
Pension  (C&P)  exam  performed  on  18  September  2002,  the  CI  complained  of  pain  primarily 
over the anterior aspect of the knee.  He also described intermittent episodes of catching, but 
denied  any  swelling  or  giving  way.    He  occasionally  used  a  brace.    Examination  revealed  a 
normal  gait  without  use  of  a  brace.    There  was  no  knee  swelling,  and  no  signs  of  ligament 
instability or meniscal injury. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and VA chose different coding options for the condition, but this did not bear on rating.  
The PEB’s 10% determination was consistent with §4.71a standards.  Although the first PT exam 
shows limitation of extension sufficient to justify only a 0% rating, there is ample evidence of 
pain with use (§4.40) or painful motion (§4.59) to warrant a 10% rating.  The Board agreed that 
a  route  to  a higher  rating  under  5257  (knee, other  impairment of)  or 5262  (tibia  and  fibula, 
impairment of) was not 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  adjudication  for  the  left  knee 
condition. 
 
Left Shoulder Condition.  An MRI performed on 17 April 2001 confirmed a partial thickness tear 
of the rotator cuff.  The right hand dominant CI did not improve with physical therapy. 
 
 
 

Left Shoulder ROM 
Flexion (0-180⁰) 

Abduction (0-180⁰) 

MEB ~8 Mo. Pre-Sep 

VA C&P ~1.5 Mo. Post-Sep 

170⁰ 
170⁰ 

“Full Active Motion” 

   2                                                           PD1200407 
 

Comments 
§4.71a Rating 

+ Painful motion 

+ Painful motion, tenderness 

10% 

10% 

 
At the NARSUM exam, the CI reported an inability to perform overhead activities or to lift heavy 
objects due to left shoulder pain.  Examination revealed no evidence of instability and normal 
strength.  Evidence of painful rotator cuff impingement was present.  The MEB examiner noted 
“full ROM with fluid motion” and weakness of the supraspinatus muscle (the key muscle of the 
rotator cuff).  X-rays were normal.  At the C&P exam, the CI reported that pain was along the 
anterior  and  superior  aspect  of  the  shoulder  and  occurred  primarily  with  overhead  activity.  
Sleeping  on  his  left  side  exacerbated  the  pain.    Examination  revealed  no  signs  of  instability.  
Evidence of painful rotator cuff impingement was present. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
VASRD  §4.71a  threshold  for  compensable  ROM  impairment  is  “shoulder  level,”  and  the 
evidence demonstrated motion well above this level.  The PEB based a 0% rating on “slight” 
disability under the 5301 code (Group I muscle injuries - ‘shoulder girdle’).  The VA’s 10% rating 
under an analogous 5203 code (impairment of clavicle or scapula) assumed non-union without 
loose movement or malunion.  Board members agreed that a 10% rating was easily supported 
based on painful use (§4.40) or painful motion (§4.59) of the shoulder joint.  It was agreed that 
there is no pathway to a rating higher than 10%.  After due deliberation, considering all of the 
evidence  and mindful  of  VASRD  §4.3  (reasonable  doubt), the  Board  recommends  a  disability 
rating of 10% for the left shoulder condition, coded 5299-5201. 
 
 
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.    The  Board  did  not 
surmise  from  the  record  or  PEB  ruling  in  this  case  that  any  prerogatives  outside  the  VASRD 
were  exercised.    In  the  matter  of  the  left  knee  chondromalacia  patellae  condition  and  IAW 
VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  In the 
matter of the left shoulder rotator cuff tear condition, the Board unanimously recommends a 
disability rating of 10%, coded 5299-5201 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 

Left Knee Chondromalacia Patellae 
Left Shoulder Rotator Cuff Tear 

 
 
 

 

VASRD CODE  RATING 
5299-5003 
5299-5201 
COMBINED 

10% 
10% 
20% 

   3                                                           PD1200407 
 

The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120427, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

             
           President 
           Physical Disability Board of Review 

   4                                                           PD1200407 
 

MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS 
                                        COMMANDER, NAVY PERSONNEL COMMAND 
 
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 
 
Ref:   (a) DoDI 6040.44 
          (b) PDBR ltr dtd 17 Dec 12  
          (c) PDBR ltr dtd 5 Dec 12  
          (d) PDBR ltr dtd 11 Dec 12  
          (e) PDBR ltr dtd 26 Nov 12  
          (f) PDBR ltr dtd 20 Nov 12  
                               
1.  Pursuant to reference (a) I approve the recommendations of the Physical Disability Board of 
Review set forth in references (b) through (f). 
 
2.    The  official  records  of  the  following  individuals  are  to  be  corrected  to  reflect  the  stated 
disposition: 
 
     a.    former USMC:  Disability separation with a final disability rating of 20 percent (increased 
from 10 percent) with entitlement to disability severance pay. 
 
     b.    former USMC:  Disability separation with a final disability rating of 10 percent (increased 
from zero percent) with entitlement to disability severance pay.  
 
     c.    former USN:  Disability separation with a final disability rating of 20 percent (increased 
from 10 percent) with entitlement to disability severance pay. 
 
     d.  former USN:  Disability separation with a final disability rating of 20 percent (increased 
from 10 percent) with entitlement to disability severance pay. 
 
     e.  former USMC:  Disability separation with a final disability rating of 20 percent (increased 
from 10 percent) with entitlement to disability severance pay. 
 
3.    Please  ensure  all  necessary  actions  are  taken,  included  the  recoupment  of  disability 
severance  pay  if  warranted,  to  implement  these  decisions  and  that  subject  members  are 
notified once those actions are completed. 
 
 
 
 
 
 
 
 
 
 
 

 
Assistant General Counsel 
Manpower & Reserve Affairs) 

 

   5                                                           PD1200407