RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

Rating 
10% 

Code 
5010-5257* 

 
NAME:  XXXXXXXXXXXXXXXXXXX                                                          BRANCH OF SERVICE:  ARMY 
CASE NUMBER:  PD1201103                                                             SEPARATION DATE:  20030327 
BOARD DATE:  20130206 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  SGT/E-5  (92A/Automated  Logistical  Specialist), 
medically  separated  for  right  knee  pain  status  post  (s/p)  anterior  cruciate  ligament  (ACL) 
reconstruction.    The  CI  initially  injured  his  right  knee  playing  soccer  in  August  of  2001.    He 
underwent two surgeries and was in the midst of the rehabilitation phase following his second 
surgery when the Army determined that he could no longer meet the physical requirements of 
his  Military  Occupational  Specialty  or  satisfy  physical  fitness  standards.    He  was  issued  a 
permanent L3 profile 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  pain  condition  as  unfitting,  rated  10%  with  application  of  the  US  Army  Physical 
Disability  Agency  (USAPDA)  pain  policy.    The  CI  made  no  appeals,  and  he  was  medically 
separated with a 10% disability rating.   
 
 
CI  CONTENTION:    “Rating  of  10%  for  right  knee  should  have  been  higher.    Rating  of  0%  for 
ankles should have been higher.”  
 
 
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 rated condition, right knee pain (s/p) 
ACL reconstruction, as requested for consideration is the only condition that meets the criteria 
prescribed  in  DoDI  6040.44  for  Board  purview;  and,  is  addressed  below.    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:   
 

Service PEB – Dated 20030106 
Code 
Condition 
Right Knee Pain S/P ACL 
5099-5003 
Reconstruction 
↓No Additional MEB/PEB Entries↓ 
Combined:  10% 
*VARD dated 20090923 changed the code to 5010-5260 but the rating remained at 10%. 
**Combined rating increased to 30% effective 20090318 when the 0% rating for Right ankle sprain was increased to 10% and a 
10% rating was added for left ankle sprain. 
 
 

VA (3 Mos. Post-Separation) – All Effective Date 20030328 
Rating 
Condition 
Right Knee ACL Tear S/P Surgery 
10% 
with Osteoarthritis 
0% X 1 / Not Service-Connected x 2 
Combined:  10%** 

Exam 
20030604 
 

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.  
 
Right  Knee  Pain  Status  Post  (S/P)  Anterior  Cruciate  Ligament  Reconstruction  Condition.    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 
Flexion (140⁰ Normal) 
Extension (0⁰ Normal) 

Comment 

§4.71a Rating 

NARSUM ~3 Mo. Pre-Sep 
135⁰ 
0⁰ 
Stable 
Lachman’s; 
negative posterior drawer; 
surgical 
incisions  well-
haled 
10% 

limp;  mild  patella  motion  tenderness,  mild 

VA C&P ~2 Mo. Post-Sep 
140⁰ (Mild pain at 140) 
70⁰ 
lateral 
No 
displacement;  negative  drawer  sign;  McMurray 
is  mildly 
positive;  no fatigability or decrease ROM with repeated motion; 
well-healed surgical scars; neurologic exam was normal 
10% 

 
The narrative summary (NARSUM) noted that the CI had a twisting injury in 2001 that resulted 
in immediate effusion and an inability to continue to play.  In October 2001, he underwent right 
knee  arthroscopy  for  a  partial  lateral  meniscectomy  and  ACL  stump  debridement.    The  CI 
continued  to  have  instability  and  pain  and  was  unable  to  extend  his  knee  completely.    His 
Lachman’s  test  was  2+.    In  September  2002,  he  underwent  an  arthroscopic  right  knee  ACL 
reconstruction.  At the NARSUM exam during his 3rd month of rehabilitation, the CI reported 
frequent, slight right knee pain and instability.  The NARSUM physical exam findings are noted 
in  the  chart  above.    The  MEB  examination  recorded  on  the  DD  Form  2808  approximately  a 
week  earlier  noted  lateral  joint  line  tenderness.    The  examiner  opined  that  the  CI  was 
“rehabilitating  as  well  as  can  be  expected  following  major  reconstruction.”    Pre-  and  post-
operative X-rays were unremarkable with standard screws for ACL reconstruction noted in the 
post-operative exams.  The commander’s statement, completed 3 months prior to separation, 
reported that the CI was unable to lift heavy equipment, to perform running and field-training 
exercises, or to deploy in the rapid response contingency unit.  At the VA Compensation and 
Pension exam performed 2 months after separation, the CI reported pain with moderate flare-
ups, exacerbated by running and prolonged walking or standing, which lasted up to 4 hours.  He 
reported his right knee was not as stable and it would occasionally lock.  He would occasionally 
use  a  knee  brace,  depending  on  his  activity.    Physical  exam  findings  are  noted  in  the  chart 
above.  The examiner opined that with an acute flare-up of the CI’s knee pain, there was “about 
25% reduction of flexion.”  Knee X-rays from June 2003 demonstrated surgical changes, minor 
osteophyte formation, and preservation of intra-articular spaces.  
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB assigned a 10% rating under an analogous 5003 code (degenerative arthritis), based on the 
USAPDA pain policy.  The VA assigned a 10% rating for 5010 (traumatic arthritis)-5257 (knee, 
other impairment of: recurrent lateral subluxation or lateral instability, slight) code based upon 
the  mild  lateral  displacement.    In  2009,  the  VA  changed  the  coding  to  5010-5260  after  an 
examination  noted  the  absence  of  knee  instability  but  the  presence  of  painful  motion.    The 
findings  reported  by  the  VA  examiner,  5  months  after  the  NARSUM  examination  during 

rehabilitation,  were  not  significantly  worse  than  those  reported  by  the  NARSUM  were; 
however, painful motion and lateral instability were documented.  Board members agreed that 
both exams would warrant a 10% rating with application of VASRD §4.59 Painful motion.  Board 
members  also  agreed  that  the  VA  exam  alone  supported  a  10%  rating  based  on  the  lateral 
instability.    Neither  coding  scheme  offers  any  advantage  to  the  CI.    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 right 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.  As discussed above, PEB 
reliance on the USAPDA pain policy for rating the right knee condition was operant in this case 
and the condition was adjudicated independently of that policy by the Board.  In the matter of 
the  right  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 
Right  Knee  Pain  Status  Post  (S/P)  Anterior  Cruciate  Ligament 
Reconstruction  

VASRD CODE  RATING 
5099-5003 
COMBINED 

10% 
10% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120627, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

            
           XXXXXXXXXXXXXXXXXXXXX, DAF 
           Acting Director 
           Physical Disability Board of Review 

SFMR-RB 
 

 

 
 

 

 

 
 

 

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 

XXXXXXXXXXXXXXXXXX, AR20130003066 (PD201201103) 

 
 

 

 
 

 

 
 
 
 

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 and hereby deny the individual’s application.   

This decision is final.  The individual concerned, counsel (if any), and any Members of Congress 

who have shown interest in this application have been notified of this decision by mail. 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

Encl 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

     XXXXXXXXXXXXXXX 

     Deputy Assistant Secretary 
         (Army Review Boards)