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AF | PDBR | CY2012 | PD2012-00729
Original file (PD2012-00729.pdf) Auto-classification: Denied
RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  ARMY 
SEPARATION DATE:  20021204 

 
NAME:  XXXXXXXXXXXXXXXX 
CASE NUMBER:  PD1200729 
BOARD DATE:  20130115 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  PFC/E‐3  (11B10/Infantry),  medically  separated  for 
chronic right knee pain.  The CI injured his right knee when he fell down a gulch during a live 
fire exercise while at Schofield Barracks.  Despite the use of a Cho‐Pat knee strap, compression 
wraps, physical therapy (PT), orthopedics evaluation, and occasional medications, 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  right  patella  chondromalacia  to  the  Physical 
Evaluation  Board  (PEB).    The  MEB  also  forwarded  left  shoulder  pain  as  meets  retention 
standards.  The PEB adjudicated the chronic right knee pain condition 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:  “I had a 2nd catscan showing more tears.  Continuation of pain and popping in 
knee.” 
 
 
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.  Any condition 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:   
 

*Effective date 20050331 because VA claim was received more than one year following discharge from military service. 
** No change to 10% right knee rating 
 
 
ANALYSIS SUMMARY:  The Board evaluates VA evidence proximal to separation in arriving at its 
recommendations,  but  its  authority  resides  in  evaluating  the  fairness  of  Disability  Evaluation 
System (DES) fitness decisions and rating determinations for disability at the time of separation.  
While  the  DES  considers  all  of  the  member's  medical  conditions,  compensation  can  only  be 
offered for those medical conditions that cut short a member’s career, and then only to the 
degree of severity present at the time of final disposition.  The Department of Veterans Affairs 
(DVA), however, is empowered to compensate service‐connected conditions and to periodically 

Service IPEB – Dated 20020924 

Condition 

Chronic Right Knee Pain 
Left Shoulder Pain 

Code 

5099‐5003 

Rating

0%

Not Unfitting

Combined:  0% 

VA (~31 Mos. Post‐Separation) – All Effective Date 20050331*
Exam

Condition

Code 

Partial Meniscectomy, R Knee

5010‐5260 

20050713

Rating 
10%** 

No VA Entry

Combined:  10% 

re‐evaluate said conditions for the purpose of adjusting the Veteran’s disability rating should 
the degree of impairment vary over time. 
 
Chronic  Right  Knee  Pain  Condition.    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. 
 

Right Knee ROM 

Flexion (140⁰ Normal) 
Extension (0⁰ Normal) 

PT ~4 Mo. Pre‐Sep

MEB‐Ortho ~4 Mo. Pre‐Sep

VA C&P ~31 Mo. Post‐Sep

110
0 

120
0

Full ROM without pain
Full ROM without pain

Comment 

Moderate antalgic gait; 
pain inferior retropatellar 
region 

ROM measured with 
goniometer; tenderness to 
palpation of the medial 
patella; no effusion;  + 
patellar grind; stable 
ligaments; no joint line 
tenderness

Gait normal; very slight 
anterior crepitus palpable 
during extreme extension; no 
redness, swelling, or 
deformity; stable in all planes 

10%

10% 

§4.71a Rating 

10%

  
The CI’s right knee condition was well documented in the service treatment record (STR) from 
December  2001  through  August  2002.    Magnetic  resonance  imaging  (MRI)  in  March  2002 
documented chondromalacia of the lateral facet and a medial meniscal tear in the right knee.  A 
right  knee  arthroscopy  with  partial  meniscectomy  was  done  in  May  2002,  approximately  7 
months prior to separation.   Intraoperative findings included Grade II to III chondromalacia of 
the patellar cartilage and the lateral facet and grade II chondromalacia of the trochlea as well as 
a  delineated  radial  tear  of  the  posterior  horn  of  the  medical  meniscus.    The  STR  notes 
documented  pain,  locking  and  popping  with  activity  continued  after  the  arthroscopy.    The 
commander’s statement documented that the CI was unable to perform the duties expected of 
all infantry soldiers and regular physical training due to the chronic pain in his knee from any 
activity.  Four months prior to separation, PT documented the right knee pain had remained 
unchanged after the arthroscopic surgery.  The PT physical exam findings are summarized in the 
chart above.  The MEB physical recorded on a DD Form 2808 approximately 5 months prior to 
separation  noted  right  knee  pain  with  flexion  and  extension.    The  MEB  narrative  summary 
(NARSUM) examination dictated 4 months prior to separation by orthopedics indicated that the 
right knee had been recalcitrant to all therapy and the CI had persistent severe right knee pain 
with  any  kind  of  activity.    A  right  knee  X‐ray  was  noted  to  be  essentially  normal  with  some 
possible  areas  of  early  arthritis.    There  was  no  subsequent  MRI  or  plain  X‐ray  after  the 
arthroscopy or at the time of the MEB exam.  The MEB NARSUM physical exam findings are 
summarized  in  the  chart  above.    The  VA  Compensation  &  Pension  (C&P)  examination 
completed approximately 31 months after separation indicated that the CI complained of pain 
with running and a catching sensation during cold weather that was brief and self‐limited.  The 
examiner did note that the CI was able to run five miles twice weekly and could walk without 
limits.    The  CI  was  employed  as  a  police  officer  at  the  time  of  the  exam  and  was  able  to 
accomplish all required tasks, but had some pain with running and other strenuous ambulatory 
activities.  The examiner further documented X‐ray findings of minimal anterior compartment 
osteoarthritic  changes.    The  C&P  physical  exam  findings  are  summarized  in  the  chart  above.  
The C&P exam performed in June 2007 over 4 years after separation referenced an MRI exam 
that was done in December 2006 that showed a new tear of the medial meniscus without any 
new abnormalities.  The examiner did not indicate any further interventions were required. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB coded the chronic right knee pain analogous to 5003 arthritis, degenerative (hypertrophic 
or  osteoarthritis)  and  rated  0%  stating  full  active  ROM  and  lack  of  joint  instability.    The  VA 
coded  the  partial  meniscectomy,  right  knee  condition  5010  arthritis,  due  to  trauma, 

   2                                                           PD1200729 
 

substantiated by X‐ray findings with 5260 leg, limitation of flexion:  flexion limited to 45 degrees 
rated as 10%.  No exam indicated limited ROM to a compensable degree absent application of 
§4.59  painful  motion.    VASRD§4.71a  specifies  for  5003  that  “satisfactory  evidence  of  painful 
motion”  constitutes  limitation  of  motion  and  specifies  application  of  a  10%  rating  “for  each 
such  major  joint  or  group  of  minor  joints  affected  by  limitation  of  motion.”    The  C&P 
examination  was  31  months  after  separation  and  therefore  the  Board  adjudged  the 
examination  to  have  a  lower  probative  value.    The  Board  considered  that  there  was  a 
preponderance of evidence for pain‐limited ROM in the STR, in the commander’s statement, 
and at the MEB NARSUM examination.  The Board adjudged that there was consistent evidence 
that the CI had painful motion of the right knee and IAW VASRD §4.59 warrants “at least the 
minimum  compensable  rating  for  the  joint.”    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 chronic right 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.    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 chronic right knee pain condition, the Board unanimously 
recommends a disability rating of 10%, coded 5099‐5003 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: 
 

Chronic Right Knee Pain 

UNFITTING CONDITION

VASRD CODE  RATING
5099‐5003 
COMBINED 

10%
10%

______________________________________________________________________________ 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120606, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 
 
SFMR‐RB 
 

           XXXXXXXXXXXXXXXXX, DAF 
           Director 
           Physical Disability Board of Review 

 
 

 
 

 

 

 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency  

 
 

   3                                                           PD1200729 
 

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

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  

for XXXXXXXXXXXXXXXXX, AR20130001634 (PD201200729) 

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 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

     XXXXXXXXXXX 

     Deputy Assistant Secretary 
         (Army Review Boards) 

 

 

 
CF:  

(  ) DoD PDBR 

(  ) DVA 

 

   4                                                           PD1200729 
 



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