RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  NAVY 
SEPARATION DATE:  20030915 

 
NAME:  XXXX 
CASE NUMBER:  PD1201141 
BOARD DATE:  20130215 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered 
individual  (CI)  was  an  active  duty  MA1/E-6  (9750/Functional  Support  and 
Administration),  medically  separated  for  status  post  (s/p)  anterior  cruciate  ligament  (ACL) 
reconstruction, left knee and degenerative joint, left knee/right ankle.  The CI had a history of 
recurring right ankle and left knee pain dating back to 1995 and 1999.  The left knee and right 
ankle  conditions  could  not  be  adequately  rehabilitated  for  the  CI  to  meet  the  physical 
requirements of his Rating or satisfy physical fitness standards.  He was placed on limited duty 
(LIMDU)  and  referred  for  a  Medical  Evaluation  Board  (MEB).    The  MEB  forwarded  no  other 
conditions for Informal Physical Evaluation Board (IPEB) adjudication.  The IPEB adjudicated the 
s/p  ACL  reconstruction,  left  knee  and  degenerative  joint,  left  knee/right  ankle  conditions  as 
unfitting,  rated  10%  and  10%,  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:  “I received two ACL reconstruction (sic) to my left knee and at this time the 
VA Hospital has recommended knee replacement.  My right ankle has damage and continues to 
deteriorate.” 
 
 
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 s/p ACL reconstruction, left knee and 
degenerative  joint,  left  knee/right  ankle  conditions  as  requested  for  consideration  meet  the 
criteria  prescribed  in  DoDI  6040.44  for  Board  purview;  and,  are  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 Board for Correction of 
Naval Records.   
 
 
RATING COMPARISON:   
 

VA (1 Mo. Pre Separation) – All Effective Date 20030916 

Service IPEB – (3 mons pre-sep) Dated 20030602 
Rating 
10% 

5299-5003 

Condition 

Code 

S/P ACL Reconstruction, 
Left Knee 
Degenerative Joint, Left 
Knee/Right Ankle 

5299-5003 

10% 

↓No Additional MEB/PEB Entries↓ 

Combined:  20% 

 
 

Condition 

S/P left Knee ACL 
Reconstruction 
Arthritis, Right Ankle 
Right Shoulder 
Impingement/Tendinitis 

Code 

5299-5259 

5010-5271 

5024 

Rating 
10% 

10% 

10% 

Exam 

20030804 

20030804 

20030804 
20030804 

0% X 2 / Not Service-Connected x 4 

Combined:  30% 

ANALYSIS  SUMMARY:    The  Board  acknowledges  the  CI’s  contention  regarding  the  significant 
impairment  with  which  his  service-connected  condition  continues  to  burden  him;  but,  must 
emphasize  that  the  Disability  Evaluation  System  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, operating under a different set of laws.   
 
Status Post ACL Reconstruction, Left Knee and Degenerative Joint, Left Knee Condition.  The CI 
had a long history of multiple sports related injuries to his left knee.  His initial injury occurred 
in 1994 and magnetic resonance imaging (MRI) results revealed tears to the left ACL as well as 
the medial and lateral menisci.  The CI underwent an ACL reconstruction in March 1995 and 
recovered well until a re-injury in 1997.  An MRI revealed a tear in the ACL graft.  A surgical 
revision of the ACL was performed in Jan 1999.  Other significant surgical history included a left 
knee arthroscopic chondroplasty with debridement of meniscal tear in May 2002.  At the MEB 
examination, (performed 5 months prior to separation) the CI reported exacerbating pain with 
prolonged standing, running, marching, and jumping activities.  The MEB physical exam noted 
painful range-of-motion (ROM) of 0-145 degrees (normal 0-140 degrees), joint line tenderness 
and  “evidence  of  mild  effusion  and  a  positive  Lachman’s”  (noted  by  ortho  note  as  1+  with 
strong endpoint).  The examiner stated “There is no ligament laxity to valgus or varus stress.  
There  is  no  distinct  laxity  noted  on  anterior  and  posterior  drawer  tests  despite  positive 
Lachman’s.”    Radiographs  demonstrated  joint  space  narrowing  and  osteophyte  formation 
consistent with degenerative changes.  The DD Form 2808, Report of Medical Exam, dated a 
week prior to the NARSUM indicated left knee crepitation with decreased flexion to 70 degrees 
(normal 140 degrees).   
 
At  the  VA  Compensation  and  Pension  (C&P)  examination,  (performed  a  month  prior  to 
separation)  the  CI  reported  constant  pain  on  ambulation,  ascending/descending  stairs, 
squatting, kneeling, and standing/sitting for long periods of time.  Radiographs demonstrated 
degenerative  arthritic  changes.    Exam  demonstrated  tenderness;  pain  limited  ROM  of  0-95 
degrees (including DeLuca) and no evidence of laxity.   
 
The  Board  directs  its  attention  to  its  rating  recommendations  based  on  the  evidence  just 
described.    Both  Service  and  VA  exams  documented  either  painful  motion  IAW  §4.59  or 
swelling  or  disability  IAW  §4.45  (the  joints)  to  warrant  a  minimum  10%  rating.    The  MEB 
examiner  reported  a  positive  Lachman’s  (instability  test),  but  stated  “no  distinct  laxity 
noted…despite the positive test.”  The CI had no incapacitating episodes proximal to his DOS.  
The  Board  deliberated  if  the  record  supported  a  higher  rating  code  5257  (knee,  other 
impairment)  for  the  presence  of  instability  rated  20%  (moderate),  or  dual  coding  for  both 
painful  motion  (due  to  degeneration)  and  for  instability.    Additionally,  the  Board  considered 
code 5262 (tibia and fibula, impairment) rated 20% (moderate) or 10% (slight) knee disability, 
but evidence did not support a 20% evaluation, or dual rating.  The Board determined that the 
degenerative arthritis code as utilized by the Service was appropriate in this case.  The Board 
discussed  the  IPEB’s  condition  description  of  separately  listing  left  knee  ACL  reconstruction 
from left knee degenerative joint and considered combining both descriptions as a single listing 
of “status post left knee ACL reconstruction with degenerative joint disease.”  However, this 
description change would not provide any benefit to the CI in reference to a rating versus the 
present IPEB analogous code for arthritis, and all knee disability was considered in the Board’s 
rating.    After  due  deliberation,  considering  all  of  the  evidence  and  mindful  of  VASRD  §4.3 
(reasonable doubt) and §4.59 (painful motion), the Board concluded that there was insufficient 
cause to recommend a change in the IPEB adjudication for the ACL Reconstruction, Left Knee 
Condition. 
 
Degenerative Joint, Right Ankle Condition.  There were three goniometric ROM evaluations in 
evidence,  with  documentation  of  additional  ratable  criteria,  which  the  Board  weighed  in 

2                                                           PD1201141 
 

arriving at its rating recommendation in regards to the right ankle condition as summarized in 
the chart below.   
 

Right Ankle ROM 

(Degrees) 

Dorsiflexion (0-20) 
Plantar Flexion (0-45) 

Comment 

LIMDU Bd. ~ 19 Mos. Pre-Sep 

MEB ~5 Mos. Pre-Sep 

VA C&P ~1 Mo. Pre-Sep 

0 
60 

Soft tissue swelling; 

in/eversion = 5 

10 
50 

15  
45 

painful ROM; in/eversion = 5 

+ Deluca 

10% 

10% 

§4.71a Rating 

10% 

 
The CI had multiple sports related injuries to his right ankle beginning in 1992.  He had a well 
documented history of degenerative joint disease to the right ankle.  At the MEB examination 
the  CI  reported  exacerbating  pain  with  prolonged  standing,  running,  marching,  and  jumping 
activities.  The MEB physical exam noted ROM from 0-50 degrees (normal 0-45 degrees) plantar 
flexion and 0-10 degrees (normal 0-20 degrees) dorsiflexion.  There was also limited inversion 
and  eversion.    MRI  of  the  right  ankle  revealed  significant  findings  consistent  with  chronic 
injuries  as  well  as  “mild  to  moderate  degenerative  thinning”  around  the  ankle  joint.    There 
were  partial  chronic  tears  of  two  ankle  ligaments.    There  was  no  evidence  suggesting  ankle 
instability,  or  presence  of  abnormal  movement,  weakness,  redness,  heat,  deformity, 
malalignment,  and  subluxation  or  guarding  of  movement. 
  Radiographs  demonstrated 
degenerative arthritic changes.  At the prior to separation  C&P examination, the CI reported 
discomfort  with  weight  bearing,  ambulation,  and  instability  ambulating  on  uneven  surfaces 
which  occur  intermittently  as  often  as  twice  per  week  and  lasting  up  to  12  hours.    The  CI 
reported no incapacitating episodes.  The C&P examination revealed painful ROM with crepitus, 
but  not  limited  by  fatigue,  weakness,  or  lack  of  endurance.    The  right  ankle  ROM  exam  is 
summarized above.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
Service and VA each rated the right ankle at 10% under different analogous codes of 5299-5003 
and  5010-5271  respectively.    The  Board  determined  that  the  CI’s  disability  picture  did  not 
support  a higher  rating under  5271  (ankle,  limited  motion)  at  20%  (marked)  nor  under  code 
5262 (tibia and fibula, impairment) at 20% (moderate) ankle disability.  The Board determined 
that under either of the above codes, the CI’s condition was consistent with a maximum rating 
of  10%.    Having  well  documented degenerative arthritic  changes  in the right  ankle,  the  IPEB 
coding of 5099-5003 is appropriate.  Ideal coding would change the description to include only 
the ankle condition with the knee considered in the rating above, but this change would offer 
no rating benefit to the CI.  After due deliberation, considering all of the evidence and mindful 
of VASRD §4.3 (reasonable doubt) and §4.59 (painful motion), the Board concluded that there 
was  insufficient  cause  to  recommend  a  change  in  the  IPEB  adjudication  for  the  right  ankle 
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.    In  the  matter  of  ACL 
reconstruction left knee condition; and the degenerative joint, left knee/right ankle conditions 
the Board unanimously recommends no change in the IPEB adjudications.  There were no other 
conditions within the Board’s scope of review for consideration.   

3                                                           PD1201141 
 

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

UNFITTING CONDITION 

s/p ACL Reconstruction, Left Knee 
Degenerative Joint, Left Knee/Right Ankle 

VASRD CODE  RATING 
5299-5003 
5299-5003 
COMBINED 

10% 
10% 
20% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120623, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 

          XXX 
           Acting Director 
           Physical Disability Board of Review 

4                                                           PD1201141 
 

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                                                           PD1201141