RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  MARINE CORPS 
SEPARATION DATE:  20030815 

 
NAME:  XX 
CASE NUMBER:  PD1201021 
BOARD DATE:  20130201 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  LCpl/E-3  (2311/Ammunition Technician),  medically 
separated for right knee osteochondral defect, medial femoral condyle.  The CI presented to 
orthopedic clinic in 2002 for right knee pain.  He underwent arthroscopy in May 2002.  The CI 
did  not  respond  adequately  to  operative  and  rehabilitative  treatment  to  meet  the  physical 
requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards 
(44).    He  was  placed  on  limited  duty  (LIMDU)  and  referred  for  a  Medical  Evaluation  Board 
(MEB).    The  MEB  forwarded  no  other  conditions  for  Physical  Evaluation  Board  (PEB) 
adjudication.  The PEB adjudicated the right knee osteochondral defect, medial femoral condyle 
condition as unfitting, rated 10%, with application of the Veteran’s Affairs Schedule for Rating 
Disabilities  (VASRD).    The  CI  made  no  appeals,  and  was  medically  separated  with  a  10% 
disability rating. 
 
 
CI  CONTENTION:    The  CI  attached  a  one  page  letter  pleading  to  his  application  which  was 
reviewed by the Board and considered in its recommendations.  He requests a rating increase 
for service connected right and left knee disabilities based on his current condition. 
 
 
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 right knee  condition requested for 
consideration  meets  the  criteria  prescribed  in  DoDI  6040.44  for  Board  purview,  and  is 
accordingly  addressed  below.    The  requested  left  knee  condition  is  not  within  the  Board’s 
purview.  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 Board for 
Correction of Naval Records. 
 
 
RATING COMPARISON: 
 

Service IPEB – Dated 20030613 
Code 

Condition 

Right Knee Osteochondral Defect, 
Medial Femoral Condyle  

5299-5003 

VA (~25 Mos. Post-Separation)– All Effective Date 20040927 

Rating 
10% 

Condition 
DJD, R Knee, S/P 
Arthroscopic Surgery 

Code 

5003-5260  

Rating 
10%* 

Exam 

20050909 

No Additional MEB/PEB Entries 

No Additional VARD Entries 

 

Combined:  10% 

Combined:  10%* 

*Effective 20040927, date claim filed, over one year post separation; R knee temporary 100% 20081110 due to surgery, then 
10% effective 20081201 post recovery; L knee 10% coded 5262-5003 effective 20081110 (combined 20%). 
 
 
 
 

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.  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  DVA,  however,  is 
empowered to compensate service-connected conditions and to periodically re-evaluate said 
conditions  for  the  purpose  of  adjusting  the  Veteran’s  disability  rating  should  the  degree  of 
impairment vary over time. 
 
Right  Knee  Osteochondral  Defect,  Medial  Femoral  Condyle  Condition.    There  were  three 
goniometric 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. 
 

Ortho ~12 Mo. Pre-

MEB ~9 Mo. Pre-Sep 

Right Knee ROM (degrees) 

Flexion (140 Normal) 
Extension (0 Normal) 

Comment:   

Surgery ~15 Mo. Pre-Sep 
Surgery >5 Mo. Post-Sep 

(2004) 

Sep 
135 
0 

Stable; 2-mos. post 

surgery)  

130 
0 

VA C&P ~25 Mo. Post-Sep 
140 (minus 10-20 w/ flare) 

0 

Stable to ENT, posterior, 

and V/V stressing;  

tenderness medial femoral 

condyle; 1+ crepitus w/ 
ROM; 6 mos. post surgery 

10% 

Note:  After post-sep surgery. 
No deformity; neg Lachman’s & 
McMurray’s; no laxity or effusion; 
estimated 10-20⁰ loss of flexion 
with flare-up; Hx lock/give way; 

10% (VA 10%) 

§4.71a Rating 

10% 

 
The narrative summary (NARSUM) noted that the CI had right knee pain for about a year prior 
to  separation  following  an  injury  to  the  right  knee.    X-rays  and  magnetic  resonance  imaging 
(MRI) of the right knee showed an osteochondral defect of the medial femoral condyle (MFC).  
The CI had surgery about 15 months prior to separation when the symptoms did not improve 
with LIMDU and physical therapy (PT).  After surgery he continued to have tenderness of the 
inside of the knee, crepitus, and pain during activity, especially running.  At the MEB exam the 
CI reported that he did not have power in his knee and the pain limited his capabilities.  The 
MEB  exam  showed  well  healed  arthroscopic  portals.    The  knee  ROMs  from  that  exam  are 
summarized in the table above.  There was no laxity of the knee.  There was tenderness at the 
medial femoral condyle with +1 crepitus to ROM.  The right lower extremity was intact to motor 
and sensory testing.  The MEB stated that the CI “is unable to run any significant distance with 
right medial knee pain and occasional swelling” and also “has difficulty with stair climbing and 
kneeling.” 
 
The  VA  Compensation  and  Pension  (C&P)  exam,  approximately  25  months  after  separation 
noted that the CI had re-injured the right knee post separation and had a second arthroscopic 
surgery (in 2004) prior to the VA exam.  At the exam the CI reported that he would wear a brace 
on his knee if doing activities that would stress his knee.  He complained of an achy pain on the 
inside of his knee since his second surgery.  It was an achy pain that could last up to a day.  It 
was improved with nonsteroidal anti-inflammatory drugs (NSAIDs).  He reported aggravation of 
his  right  knee by  sitting  or  standing too  long,  and that  walking did  not  really  affect his  knee 
pain, but that walking caused lock-up and stiffness.  He reported flare-ups involving lock-up and 

2                                                           PD1201021 
 

stiffness that would be once per week and last a little while.  The right knee would give out 
once in a while.  He reported swelling most of the time in his knee.  The VA exam showed a 
normal gait, with muscle strength 5/5, normal sensation.  The CI was able to walk on his heels, 
toes,  and  squat  without  pain.    His  knee  was  able  to  extend  to  zero  degrees  and  flex  to  140 
degrees.    There  was  no  tenderness  to  palpation  of  the  patella;  no  laxity;  no  effusion  were 
noted.    X-ray  of the  right  knee  showed degenerative  joint  disease  (DJD)  and possible  medial 
femoral  condyle  osteochondral  damage.    The  VA  examiner  stated  that    “The  Deluca  issue  is 
primarily pain.  It is estimated there is a 10 to 20 degrees loss of flexion with flare-up”. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  rated the  right  knee  osteochondral  defect,  medial  femoral  condyle,  surgically  treated  as 
5299-5003 at 10%.  The VA rated DJD, right knee, status post arthroscopic surgery as 5003-5260 
(Arthritis  limiting  flexion  of  the  leg)  also  at  10%  for  painful  motion.    5003  (Degenerative 
arthritis)  and  5260  (Limitation  of  leg  flexion)  are  appropriate  codes  to  consider  in  this  case.  
Either of these codes results in a rating of 10% for the right knee condition.  Coding as 5299-
5255  (analogous  to  Femur,  impairment  of)  was  deliberated  because  the  CI’s  diagnosis  was 
osteochondral (OC) defect, which involves the bone and cartilage of the femur at the knee joint.  
The Board deliberated if the persistent tenderness of the MFC was comparable to a malunion of 
the femur under this code, and if the CI met the moderate knee disability (20%) criteria of 5255.  
Based  on  the  CIs  functional  capabilities,  described  in  the  record  as  “able  to  do  some  light 
treadmill and bicycle aerobic activity,” and lack of frequent effusions into the joint, the Board 
adjudged the record supported the CI’s knee condition to be a mild (10%) knee disability under 
code 5255 at the time of separation.  The Board opined that the original PEB rating code of 
5299-5003 was a better match to the CI’s disability picture.  After due deliberation, considering 
all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that 
there was insufficient cause to recommend a change in the PEB adjudication for the right knee 
osteochondral defect, medial femoral condyle 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 right knee osteochondral defect, medial femoral condyle 
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: 
 

VASRD CODE  RATING 
5299-5003 
COMBINED 

10% 
10% 

Right Knee Osteochondral Defect, Medial Femoral Condyle 

UNFITTING CONDITION 

 
 

 

3                                                           PD1201021 
 

The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120625, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

           xx 
           Acting Director 
           Physical Disability Board of Review 

4                                                           PD1201021 
 

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

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

5                                                           PD1201021