RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
SEPARATION DATE: 20030715
NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY
CASE NUMBER: PD1200853
BOARD DATE: 20130115
SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this
covered individual (CI) was an active duty Soldier, SSG/E‐6 (77F/Petroleum Supply Specialist),
medically separated for right knee chondromalacia. She had a history of right anterior knee
pain since 1994. In 2002, she was diagnosed with chondromalacia by magnetic resonance
imaging (MRI) and underwent arthroscopic surgery. The CI did not improve adequately with
treatment to meet the physical requirements of her Military Occupational Specialty or to satisfy
physical fitness standards. She was issued a permanent L3 profile and referred for a Medical
Evaluation Board (MEB). The MEB forwarded right knee chondromalacia as medically
unacceptable IAW AR 40‐501. The MEB forwarded no other conditions for Physical Evaluation
Board (PEB) adjudication. The PEB adjudicated the right knee chondromalacia as unfitting,
rated 0%, with likely application of the US Army Physical Disability Agency (USAPDA) pain
policy. The CI made no appeals and was medically separated with a 0% disability rating.
CI CONTENTION: The CI states: “I am serious problems [sic] with my knees and walking
becoming difficult [sic] due to my knees locking‐up at least twice a week. My problem is
becoming so serious I have to walk on my tip toes to relieve the severe pain in my knees.”
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 unfitting right knee condition as
requested for consideration meets the criteria prescribed in DoDI 6040.44 for Board purview;
and, is addressed below. The implied contention for the left knee condition, and 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:
VA (7 Mos. Post‐Separation) – All Effective Date 20030716
Condition
Post Op Residual, DJD, R Knee
Hysterectomy
DJD, Bilateral Hands
DJD, L Knee
Mechanical LBP w/Retrolisthesis
R Varicose Veins
L Varicose Veins
0% X 4 / Not Service‐Connected x 4
Combined: 80%*
Code
5261‐5010
7617
5010
5261‐5010
5237
7120
7120
Rating
10%
50%
10%
10%
10%
10%
10%
Exam
20040223
20040223
20040223
20040223
20040223
20040223
20040223
20040223
Service PEB – Dated 20030325
Condition
Right
Chondromalacia
Knee
Code
5009‐5003
Rating
0%
↓No Addi(cid:415)onal MEB/PEB Entries↓
Combined: 0%
*Includes bilateral factor of 4.26%
ANALYSIS SUMMARY:
Right Knee Chondromalacia. The goniometric range‐of‐motion (ROM) evaluations in evidence
which the Board weighed in arriving at its rating recommendation, with documentation of
additional ratable criteria, are summarized in the chart below.
Right Knee ROM
(Degrees)
Flexion (140 Normal)
Extension (0 Normal)
Comment: Surgery 10 Mo.
Pre‐Sep
§4.71a Rating
VA C&P ~7 Mo. Post‐Sep
125
0
Painful motion; considerable
guarding
10%
MEB ~6 Mo. Pre‐Sep
120
0
Painful
effusion;
tenderness; crepitus; +grind; stable
10% (PEB 0%)
motion;
The CI underwent arthroscopic surgery in May 2002, 10 months before separation for
chondromalacia, followed by persistent post‐operative anterior knee pain despite physical
therapy, profiles, and pain medication. The narrative summary performed in January 2003, 6
months before separation, noted tenderness to palpation, with positive crepitus and grind. The
knee was otherwise stable with a negative Lachman's test and varus and valgus stress tests.
The painful ROM is summarized in the chart above. An MRI was consistent with Type I
chondromalacia of both the patellofemoral joint and medial femoral condyle. At the VA
Compensation and Pension exam in February 2004, 7 months after separation, the CI reported
chronic right knee pain and difficulty with prolonged walking. No supportive devices were
required. Although unemployed since her military separation, she said that she had no
problems getting a job but wanted to take care of her health before starting work. On physical
exam, her knee appeared slightly inflamed, with pain on movement and no tenderness to
palpation. Knee X‐rays in February 2004 showed mild degenerative osteoarthritis. The exam
diagnosed early right knee degenerative joint disease with minimal to mild functional loss of
ROM due to pain.
The Board directs attention to its rating recommendation based on the above evidence. There
was no limitation of motion or instability to warrant a minimum rating under the respective
VASRD diagnostic codes (5260, 5261 or 5257). All exams documented pain‐limited motion IAW
VASRD §4.59 (Painful motion) and other findings for functional loss IAW §4.40 which support a
rating of 10%. After due deliberation, considering all of the evidence and mindful of VASRD
§4.3 (Resolution of reasonable doubt) and §4.59 (Painful motion), the Board recommends a
disability rating of 10% for the right knee chondromalacia 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. As discussed above, PEB
reliance on the USAPDA pain policy for rating the right knee chondromalacia was likely operant
in this case and the condition was adjudicated independently of that by the Board. In the
matter of the right knee chondromalacia condition, the Board unanimously recommends a
disability rating of 10%, coded 5009‐5003 IAW VASRD §4.71a. There were no other conditions
within the Board’s scope of review for consideration.
2 PD1200853
RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as
follows, effective as of the date of her prior medical separation:
VASRD CODE RATING
5009‐5003
COMBINED
10%
10%
UNFITTING CONDITION
Right knee chondromalacia
The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20120705, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record
SFMR‐RB
XXXXXXXXXXXXX, DAF
President
Physical Disability Board of Review
MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD‐ZB / XXXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA 22202‐3557
SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXX, AR20130001362 (PD201200853)
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:
3 PD1200853
Encl
XXXXXXXXXXX
Deputy Assistant Secretary
(Army Review Boards)
CF:
( ) DoD PDBR
( ) DVA
4 PD1200853
AF | PDBR | CY2013 | PD-2013-02209
The Board considered that the evidence in record supports that the CI had painful, limited ROM with imaging evidence of DJD following right knee injury and surgery, without significant instability. Left knee examination was the same as the right, except no effusion was present and physical therapy noted ROM of 0 degrees-130 degrees, without painful motion.At the VA C&P exam performed a week after separation the CI reported problems in the left knee due to compensation for his right knee. ...
AF | PDBR | CY2011 | PD2011-00832
The FPEB and VA each coded the individual knees at 10% using the criteria for arthritis (5003), with the VA indicating a traumatic onset by using code 5010. Left Knee : With regards to the left knee, the Board considered that the preponderance of the record supported the 10% rating for the left knee for limited motion. RECOMMENDATION : The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:
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The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of theVeterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. Left Shoulder Condition. In the matter of the left shoulder pain condition, the Board unanimously recommends a disability rating of 10%, coded 5099-5003 IAW VASRD §4.71a.
AF | PDBR | CY2012 | PD-2012-01678
The right knee condition, characterized as right knee chondromalacia patella, anterior knee pain syndrome, and nonunion of patellar fracture, was forwarded to the Physical Evaluation Board (PEB) as medically unacceptable IAW AR 40-501. Right Knee ROM MEB 4 mos. RECOMMENDATION: The Board, therefore, recommends that there be no recharacterization of the CIs disability and separation determination, as follows: UNFITTING CONDITION VASRD CODE RATING Chronic, Painful Right Knee...
AF | PDBR | CY2013 | PD2013 00143
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AF | PDBR | CY2013 | PD-2013-01564
Those measurements are summarized in the chart below.Two months prior to separation from service, the CI had a VA Compensation and Pension (C&P) exam, the examiner noted that the CI was walking with a limp, and using a cane. Right Knee ROM (Degrees)MEB ~ 7 mos. In the matter of the right knee pain condition, the Board unanimously recommends a 10% disability rating, coded 5299-5259 IAW VASRD §4.71a.
AF | PDBR | CY2013 | PD-2013-01589
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AF | PDBR | CY2012 | PD2012-01327
RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW BRANCH OF SERVICE: NAVY SEPARATION DATE: 20030527 NAME: XX CASE NUMBER: PD1201327 BOARD DATE: 20130206 SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty PO2/E-5 (PH2/Photographer's Mate) medically separated for chondromalacia, right medial femoral condyle and trochlea. There were no other conditions within the Board’s scope of review for consideration. ...
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SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SGT/E-5 (67U20/CH-47 Helicopter Repairman) medically separated for a right knee condition. Right Knee Condition . In the matter of the right knee condition, the Board unanimously recommends a dual coding disability rating for a combined rating of 30%, IAW VASRD §4.71a.
AF | PDBR | CY2011 | PD2011-00716
(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. At the VA Compensation and Pension (C&P) exam, performed 5 months after separation, the CI reported pain in the left knee on an intermittent basis without loss of motion, and confirmed that...