RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  NAVY 
SEPARATION DATE:  20011207 

 
NAME:  XX 
CASE NUMBER:  PD1201033 
BOARD DATE:  20130129 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty Petty Officer 3rd Class/E-4 (AD3/Aviation Machinist 
Mate), medically separated for chronic posterior cruciate ligament deficient, left knee.  Despite 
treatment, the instability continued and the CI was unable to participate in physical readiness 
training or other strenuous activity.  He was placed on limited duty (LIMDU) in August 1999.  He 
was continued in LIMDU status by the August 1999 board and was later referred for a Medical 
Evaluation Board (MEB) in March 2000, October 2000 and March 2001.  Each of these boards 
continued his LIMDU status for an additional 8 months.  The August 2001 MEB referred his case 
to  the  Physical  Evaluation  Board  (PEB)  with  no  other  conditions  for  adjudication.    The  PEB 
adjudicated the left knee condition as unfitting, rated 20%, with application of the Veteran’s 
Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals, and was medically 
separated with a 20% disability rating.   
 
 
CI CONTENTION:  The CI elaborated no specific contention in his application.   
 
 
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 (left knee) will be reviewed in all cases.  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 service Board for Correction of Military Records.   
 
 
RATING COMPARISON:   
 

*The VA increased his knee rating to 10% effective 16 May 2007.   
 
 
ANALYSIS SUMMARY:  
 
Chronic posterior cruciate ligament deficient, left knee Condition.  The CI sustained a left knee 
injury  in  1999  when  a  ladder  collapsed  on  him.    The  CI  was  immediately  evaluated  and 
diagnosed with a posterior cruciate ligament tear.  He was given a sports brace and enrolled in 
physical therapy (PT), however the CI continued to complain of knee instability and “catching” 
sensation of the knee.  Arthroscopic surgery was performed on the left knee in June 2000 with 
an  attempt  to  thermally  shrink  the  posterior  ligament.    Postoperative  rehabilitation  and 

Service IPEB – Dated 20010918 
Condition 

Code 
5257 

Rating 
20% 

Chronic posterior cruciate 
ligament deficient, left knee 

↓No Additional MEB/PEB Entries↓ 

Combined:  20% 

VA (2 ½ wks. Pre-Separation) – All Effective Date 20011208 

Condition 

Code 

Rating 

Exam 

Left, knee arthroscopy; s/p PCL 
shrinkage 

5299-5024 
0% X 0 / Not Service-Connected x 0 

0% 

20011120 
20011120 

Combined:  0% 

physical therapy was recommended, however the CI continued to complain of pain and knee 
instability especially when running.  A magnetic resonance imaging (MRI) exam performed on 
8 April 2001 evidenced both anterior and posterior cruciate ligament strains.  A sports medicine 
examination  10  April  2001  noted  complaint  of  knee  buckling  without  a  brace.    There  was 
normal range-of-motion (ROM) with a stable anterior cruciate ligament but with an unstable 
posterior  cruciate  ligament.    There  were  three  goniometric  ROM  evaluations  in  evidence 
proximate  to  separation,  with  documentation  of  additional  ratable  criteria,  which  the  Board 
weighed in arriving at its rating recommendation; as summarized in the chart below.   
 

MEB/NARSUM 
~4 Mo. Pre-Sep 

(20010810) 

130 
0 

VA C&P 

~3 Wks Post-Sep 

(20011120) 

140 
0 

No instability 
Normal Gait 

0% 

Sports Clinic 
~8 Mo. Pre-Sep 

(20010410) 

130 
0 

Left Knee ROM 

(Degrees) 

Flexion (140 Normal) 
Extension (0 Normal) 

Comment:   

 

§4.71a Rating 

Instability of PCL 

Instability of PCL 

10% 

10% 

 
The MEB narrative summary (NARSUM) examination, 10 August 2001, noted full ROM for the 
left knee, no tenderness, swelling, or effusion.  The knee was stable to varus and valgus stress 
at 0 and 30 degrees.  The CI had a posterior drawer test positive, positive quadriceps active test 
and  positive  Sag  sign  characteristic  for  a  posterior  cruciate  ligament  injury.    The  examiner 
considered the CI condition as a chronic posterior cruciate ligament deficiency of the left knee.  
At  the  VA  Compensation  and  Pension  (C&P)  exam,  20  November  2001,  2  weeks  prior  to 
separation, the CI reported pain, swelling, instability of the left knee with daily flare ups that 
could  become  severe  with  overuse.    The  symptoms  were  alleviated  by  medication  and  rest.  
The  physical  exam  evidenced  tenderness  to  compression  of  the  left  knee  with  crepitus, 
however ROM was normal (and equal to the opposite knee) and no inflammation of the left 
knee  was  noted.    X-ray  exam  of  the  left  knee  was  normal.    Tests  for  instability  (drawer, 
Lachman, pivot shift) and meniscus signs were negative.  Gait was normal as well as muscular 
and neurological exam.  The CI did not show any signs of abnormal weight bearing, he did not 
require  assistive  device  for  walking,  or  shoe  inserts.    At  that  time,  he  had  no  limitations  of 
standing or walking.  The Board directs attention to its rating recommendation based on the 
above evidence.  The PEB rated the condition 20% under code 5257 considering recurrent knee 
instability.    The  VA  rated  the  condition  0%  based  on  the  C&P  examination  which  did  not 
document examination findings of instability.  There was no limitation of motion to warrant a 
rating  under  the  respective  VASRD  codes  (5260  and  5261).    There  was  not  a  dislocated 
meniscus with locking to support a rating under code 5258 (dislocated meniscus).  Considering 
the 5257 code used by the PEB, the Boards noted the objective evidence of knee instability on 
the  MEB  examination  supported  no  more  than  the  20%  rating  adjudicated  by  the  PEB.    The 
Board discussed whether the evidence more nearly approximated the 10% rating however the 
Board may not recommend a rating lower than the PEB.  The Board concluded there was no 
evidence  of  severe  instability  to  support  a  higher  rating  and  there  was  no  objective  painful 
motion on examinations to support an additional rating.  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 chronic posterior 
cruciate ligament deficient, 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  chronic posterior  cruciate  ligament deficient,  left  knee 

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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 

5257 

COMBINED 

20% 
20% 

 
  Acting Director 
  Physical Disability Board of Review 

Chronic Posterior Cruciate Ligament Deficient Left Knee 

UNFITTING CONDITION 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120608, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

xx 

 
 
 

 

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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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