RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  MARINE CORPS 
SEPARATION DATE:  20020515 

 
NAME:  XXXXXXXXXXXXXXXX 
CASE NUMBER:  PD1200858 
BOARD DATE:  20130227 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  PFC/E-2  (6123/Helicopter  Dynamic  Mechanic), 
medically  separated  for  left  knee  patellar  chondromalacia  (left  knee  condition).    He  was 
originally  injured  while  operating  a  motorcycle  in  1998  and  has  had  both  lateral  and  medial 
knee pain since with some episodes of catching and giving way.  In November of 2001 he had a 
left knee arthroscopy with a near total medial meniscectomy for a chronic bucket handle tear 
of the meniscus.  Since his surgery, he had improvement with the catching, but continued pain 
with  no  further  course  of  action  available.    Despite  the  surgery  and  physical  therapy,  the  CI 
could  not  be  adequately  rehabilitated  to  meet  the  physical  requirements  of  his  Military 
Occupational  Specialty  satisfy  physical  fitness  standards.    In  1999 the  CI  met  his  first  limited 
duty (LIMDU) Board for myofascial pain and was placed on an 8 month LIMDU.  The case was 
not  forwarded  to  a  Physical  Evaluation  Board  (PEB).    In  September  of  2001,  the  CI  met  his 
second  LIMDU  board  for  chronic  left  knee  pain  with  evidence  of  displaced  medial  meniscus 
tear.  Two months later he had arthroscopic surgery and the Medical Evaluation Board (MEB) 
was placed on hold.  Two months post surgery he was placed on his third LIMDU and referred 
for a MEB.  The conditions forwarded to the PEB were left knee medial meniscus tear and left 
knee patellar chondromalacia.  Both conditions are identified in the rating chart below.  The 
PEB adjudicated the left knee condition as not unfitting and recommended the CI was “Fit to 
Continue on Active Duty.”  The CI requested a Records Review Panel reconsideration of his case 
and filed a 2 page statement outlining why “the findings are not compatible with the evidence 
provided and the condition I currently have.”  The Records Review Panel agreed with the CI and 
changed the rating to an unfit left knee patellar chondromalacia, rated 10% with application of 
the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The left knee medial meniscus 
tear was determined to be a Category II condition (contributing to the unfitting condition).  The 
CI made no appeals, and was medically separated with a 10% disability rating.   
 
 
CI CONTENTION:  “Continued unstability [sic] &  left knee pain”   
 
 
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 conditions left medial meniscal tear, 
implied  from  the  CI’s  contention  “left  knee  pain,”  as  requested  for  consideration  meets  the 
criteria prescribed in DoDI 6040.44 for Board purview; and, is addressed below, in addition to a 
review  of  the  Service  rating  for  the  unfitting  condition.    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:   
 

Code 
5299-5003 

Knee 

Patellar 

Service Recon PEB – Dated 20020321 
Condition 
Lt 
Chondromalacia 
Lt  Knee  Medial  Meniscus 
Tear 
↓No Additional MEB/PEB Entries↓ 
Combined:  10% 

CAT II 

Rating 
10% 

Code 

VA (2 Mos. Pre -Separation) – All Effective Date 20020516 
Condition 
No VA Entry 
Residuals, 
Debridement 
Meniscus, Lt Knee 
0% X 3 / Not Service-Connected x 3 
Combined:  10% 

S/P  Arthroscopy, 
Medial 

5258-5257 

Rating 

10% 

of 

Exam 

20020311 

20020311 

 
 
ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding  the  significant  impairment  with  which  his  service-incurred  condition  continues  to 
burden him.  The Board wishes to clarify that it is subject to the same laws for service disability 
entitlements as those under which the Disability Evaluation System (DES) operates.  The DES 
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 (DVA), operating under 
a  different  set  of  laws  (Title  38,  United  States  Code).    The  Board  evaluates  DVA  evidence 
proximal to separation in arriving at its recommendations, but its authority resides in evaluating 
the  fairness  of  DES  fitness  decisions  and  rating  determinations  for  disability  at  the  time  of 
separation. 
 
Left Knee Condition.  The CI sought care for over 4 years for left knee pain after an injury from 
operating  a  motorcycle.    The  pain  was  located  anterior  and  medial  with  some  catching  and 
giving way but no locking.  He had some mild intermittent effusions (swelling).  The pain was 
aggravated with stair climbing, “Indian style” sitting, prolong standing, and relieved minimally 
with the non-steroidal anti-inflammatory medication, Motrin.  He ultimately opted for surgical 
intervention, arthroscopy, which found two knee pathologies, chrondromalacia of the patella 
and femoral condyle and a large bucket handle tear of the medial meniscus, which was partially 
debrided.  The surgery did not resolve his pain.  The non-medical assessment documented that 
he was performing assigned maintenance tasks, as long as they do not require prolong standing 
however was unable to participate in physical training testing, marksmanship training, martial 
arts training and he was not World Wide Deployable.  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 Post-Surgery ~5 Mo. Pre-Sep  MEB C&P ~4 Mo. Pre-Sep 
110⁰ 
3⁰ 
 
0% 

130⁰ 
0⁰ 
no laxity 
0% 

PCC ~2 Mo. Pre-Sep 
100⁰ 
0⁰ 
Reinjured – Grade I MCL strain 
0% 

 
The  MEB  physical  exam  demonstrated  normal  patellar  tracking,  no  effusion,  mild 
patellofemoral  crepitus,  mildly  positive  patellar  compression  test,  abnormal  patella  glide, 
normal provocative ligament, and meniscal testing, and tenderness to palpation on the medial 
aspect of his knee.  The examiner documented he was eight weeks status post (s/p) left knee 
arthroscopy  with  a  near  total  medial  meniscectomy  for  a  chronic  bucket  handle  tear  of  the 
meniscus with improvement of the catching in his knee, however the pain was still persistent 
both medial and anterior and he has not been able to return to vigorous activity.  The examiner 
further opined since surgery did not correct most of his pain that more than likely most of the 
pain pathology was coming from the anterior knee for which there was no corrective surgery.  

2                                                           PD1200858 

Until the PEB process was final the examiner recommended no forced marches, formation runs, 
physical fitness testing, lifting or carrying more than ten pounds, squatting or twisting activities.  
 
At  the  VA  Compensation  and  Pension  (C&P)  exam  prior  to  separation,  the  CI  reported  daily 
pain,  stiffness,  fatigability  and  lack  of  endurance,  but  there  was  no  locking.    The  actual  C&P 
orthopedic exam of the left knee for this C&P exam was not in evidence.  X-ray revealed lower 
than normal width of the patellofemoral joint and otherwise within normal limits.  The VA left 
knee exam in February 2004 demonstrated; the gait on level is normal with a mild suggestion of 
lateral thrust at the knee on heel strike, was able to walk on tip toes and heel, had a hard time 
doing  a  deep  knee  bend  and  particularly  getting  up  again,  no  swelling  or  effusion  and  no 
specific ligament laxity.  With regards to ROM there was 10 degrees hyperextension bilatalerally 
and full flexion with mild discomfort in flexing at the extremes.  No patella signs, specifically no 
crepitus of the patellofemoral joint, tracking ok and negative patella inhibition and grind tests.  
Positive meniscal provocative testing (McMurray’s) with pain noted on the lateral side.  X-rays 
were ordered and no confirmatory diagnosis was made for the left knee pain. 
 
The Board directs attention to its rating recommendation based on the above evidence.  Both 
the  unfitting  condition  and  the  Category  II  condition  for  the  left  knee  are  considered  in  the 
analysis below.  The PEB and VA chose different coding options for the condition which had 
some implications on the rating for the Board to consider yet they both assigned the same 10% 
rating  which  is  consistent  for  either  code  IAW  §4.71a—Schedule  of  ratings–musculoskeletal 
system.  The PEB coded analogous to 5003 (arthritis, degenerative) for pain resulting from the 
left  chondromalacia  patella  pathology  and  determined  the  residuals  of  the  medial  meniscal 
pathology contributed to the patella pathology.  The VA coded analogous to 5257 (Recurrent 
subluxation or lateral instability) for slight recurrent subluxation or lateral instability of the knee 
for the residual of the left knee medial meniscus debridement.  Members agreed there is no 
evidence of ligament instability or recurrent subluxation to support a rating with the 5257 code 
or  to  consider  dual  coding.    The  Board  notes  the  analogous  code  used  by  the  VA  5258 
(Cartilage,  semilunar,  dislocated,  with  frequent episodes  of  “locking,”  pain,  and  effusion  into 
the joint) can result in a 20% rating however the VA chose not to assign the higher rating likely 
due to lack of evidence to support this criteria.  Members also agreed the evidence does not 
support  “locking”  and  or  frequent  knee  effusions,  rather  intermittent.    There  is  in-service 
diagnosis of chondromalacia patella pathology and medial meniscal pathology however; there 
was not medical certainty of any clear error in PEB unfitting diagnosis.  The Board agreed it is 
the knee pain which results in the CI’s functional impairments which could either come from 
either  pathology  or  both  and  therefore  could  consider  a  rating  with  5003  or  with  5259 
(Cartilage,  semilunar,  removal  of,  symptomatic).    However,  IAW  VASRD  §4.14  (Avoidance  of 
pyramiding) the Board could not consider coding the residual pain from either pathology with 
both codes.  There is no evidence of incapacitation episodes to support the 20% higher rating 
under 5003 and the highest rating is 10% for the 5259 code.  Therefore 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 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 
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.   

3                                                           PD1200858 

RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows:   
 

VASRD CODE 
5299-5003 
 
COMBINED 

RATING 
10% 
CAT II 
10% 

UNFITTING CONDITION 
Lt Knee Patellar Chondromalacia 
Lt Knee Medial Meniscus Tear 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120505, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

XXXX 
Acting Director 
Physical Disability Board of Review 

4                                                           PD1200858 

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 8 Mar 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 USMC 
-    former USMC 
-    former USN   
-   former USMC 
-   former USMC 
-   former USN  
-   former USMC 
  
 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  XXXXXX 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

5                                                           PD1200858