RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  MARINE CORPS 

 
NAME:  XX                                                   
CASE NUMBER:  PD1200848                                                  SEPARATION DATE:  20020228 
BOARD DATE:  20130131 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty LCPL/E-3 (2146/Main Battle Tank Repair Technician), 
medically separated for instability of left knee, status post (s/p) left anterior cruciate ligament 
(ACL)  reconstruction.    CI  initially  injured  his  knee  playing  football  in  September  2000.    He 
received physical therapy, bracing, and nonsteroidals.  The left knee condition did not improve 
adequately  with  treatment  and  the  CI  was  unable  to  meet  the  physical  requirements  of  his 
Military Occupational Specialty or satisfy physical fitness standards.  He was placed on limited 
duty and referred for a Medical Evaluation Board (MEB).  The two conditions, identified in the 
rating chart below, were also identified and forwarded by the MEB.  The Physical Evaluation 
Board  (PEB)  adjudicated  the  instability  of  left  knee  condition  as  unfitting,  rated  10%.    The 
remaining conditions were determined to be not unfitting and determined to be Category II.  
The CI made no appeals, and he was medically separated with a 10% disability rating.   
 
 
CI  CONTENTION:    “Knee  is  torn  again  (ACL)  and  grossly  unstable.    Severe  back  pain  from 
favoring one leg all the time.”   
 
 
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  other  requested  condition of back 
pain  is  not  within  the  Board’s  purview.    Any  conditions  or  contentions 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:   
 

Code 

Rating 

5257 

10% 

Code 

Rating 

VA (5.5 Mos. Post-Separation) – All Effective Date 20020301 
Condition 
Exam 

Service IPEB – Dated 20020110 
Condition 
Instability of Left Knee, status post Left 
Anterior 
Ligament 
Reconstruction 
Mild  Amount  of  Pain  with  Prolonged 
Standing or Running 
Grade  I  Medial  Collateral  Ligament 
Injury 
↓No Additional MEB/PEB Entries↓ 
Combined:  10% 
*The CI failed to show for his scheduled C&P examination and  his original rating Initial rating  was 0% based on the service 
records that did not include ROM measurements.  However, after the C&P exam noted above was completed, the rating was 
changed to 10% with the same effective date of 20020301.  The rating was temporarily increased to 100% effective 20031113 
for surgery but was then decreased back to 10% effective 20040101.  
 
 

Left  Knee  Injury,  Lateral 
Meniscal  Tear;  S/P  ACL 
Reconstruction 

Lumbosacral Strain 
Combined:  30% 

Cat II 

Cat II 

*10% 

20020816  

20% 

20020816 

Cruciate 

5260 

5295 

ANALYSIS SUMMARY:  The Board’s authority as defined in DoDI 6040.44, resides in evaluating 
the  fairness  of  Disability  Evaluation  System  fitness  determinations  and  rating  decisions  for 
disability at the time of separation.  The Board utilizes 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  the  time  of 
separation. 
 
Instability  of  Left  Knee  Condition.    The  goniometric  range-of-motion  (ROM)  evaluations  in 
evidence  which  the  Board  weighed 
its  rating  recommendation,  with 
documentation of additional ratable criteria, are summarized in the chart below. 
 

in  arriving  at 

Left Knee ROM 
Flexion (140⁰ Normal) 
Extension (0⁰ Normal) 

Comment 

§4.71a Rating 

I-II  pivot 

Ortho ~5 Mo. Pre-Sep 
“Full”  
  
shift,  10mm 
Instability;  graded 
  with 
Lachman’s;  opens  approximately  8mm 
line  tenderness; 
valgus  stress;  negative 
negative  McMurray;  no  effusion;  decreased 
sensation  in  infrapatellar  branch  of  saphenous 
nerve region, otherwise NVI 
 10% 

joint 

VA C&P ~5.5 Mo. Post-Sep 
120° 
0⁰ 
Lachman’s  and  anterior  drawer  mildly 
positive as compared to right; ; McMurray 
normal;  audible  popping  noises  with 
repeated 
feeling  of  grinding 
within the knee; no swelling 
10 % 

flexion; 

 
After  the  injury  in  September  2000,  magnetic  resonance  imaging  indicated  a  large  lateral 
meniscal tear and a complete loss of the ACL and in December 2000 the CI underwent surgery 
left knee lateral meniscal tear repair and ACL reconstruction.  After separation from service in 
February 2002, the CI reinjured his left knee in June 2003 and underwent a revision of the left 
knee ACL reconstruction in November 2003.  At the MEB report completed by an orthopedic 
surgeon approximately 5 months prior to separation, the CI reported an inability to do pivoting 
activities.  He had initially done well after surgery but around the 90-120 day time period after 
surgery, he began to have symptoms of instability with pivoting activities.  At that time, he had 
a Lachman’s of 10mm, Grade I pivot shift, and opening of the medial side with valgus stress.  
However, a subsequent exam noted that the Lachman’s of 10mm was only 1 mm different from 
the  asymptomatic  right  side  and  further  surgery  was  not  recommended.    The  MEB  report 
physical  exam  noted  “full  range  of  motion”  but  no  actual  measurements  were  provided.  
Physical examination findings are in the ROM chart above.  The VA Compensation and Pension 
exam  completed  5  months  after  separation  included  a  similar  clinical  history  and  the  CI 
reported  persistent  stiffness  and  discomfort  and  fatigability,  with  precipitating  factors  that 
included kneeling and squatting or standing for prolonged periods.  Physical exam findings are 
documented in the ROM chart above.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  assigned  a  10%  rating  for  instability  using  the  Veterans  Affairs  Schedule  for  Rating 
Disabilities  (VASRD)  code  5257.    The  VA  also  assigned  a  10%  rating  effective  the  day  after 
separation; however, using VASRD code 5260 and the rating was based on painful or limited 
motion.  Both examinations document mild joint instability as compared to the right knee and 
neither examination contains evidence of a recurrent meniscal injury or limitation of ROM at a 
compensable  level.    After  due  deliberation,  considering  all  of  the  evidence  and  mindful  of 
VASRD §4.3 (Resolution of reasonable doubt), the Board concluded that there was insufficient 
cause to recommend a change in the PEB adjudication for the instability of left knee 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 

   2                                                           PD1200848 
 

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 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 
Instability of Left Knee, status post Left Anterior Cruciate Ligament 
Reconstruction  

VASRD CODE  RATING 
5257 
COMBINED 

10% 
10% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120602, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

                   xx 
                   Director 
                   Physical Disability Board of Review 

   3                                                           PD1200848 
 

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW  
                                        BOARDS  

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 

Ref:   (a) DoDI 6040.44 

             (b) CORB ltr dtd 21 Feb 13 
 

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for 
the reasons provided in their forwarding memorandum, approve the recommendations of the PDBR 
that the following individual’s records not be corrected to reflect a change in either characterization 
of separation or in the disability rating previously assigned by the Department of the Navy’s 
Physical Evaluation Board: 
 
 
 
 
 

 
 
 
 

 

 

     
 
 
 
 

-  former USN  
-  former USN  
-  former USMC 
-  former USN   
-  former USMC 
-  former USN  
-  former USN   
-  former USN 
-  former USMC 
-  former USMC 
-  former USMC 
-  former USMC 
 
  

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xxxx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

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