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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