RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXX	CASE:  PD-2013-01051
BRANCH OF SERVICE:  Army	BOARD DATE:  20140620
SEPARATION DATE:  20020208

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (92A/Automated Supply Specialist) medically separated for left knee pain status post two posterior cruciate ligament (PCL) reconstructions.  The left knee condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards.  He was issued a permanent U3L3 profile and referred for a Medical Evaluation Board (MEB).  The left knee condition was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The Informal PEB adjudicated the left knee condition as unfitting, rated 10%, with likely application of the VA Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.

CI CONTENTION:  “I was never told what my rating was, only that I did not qualify for retirement.  The personnel working the documentation for MEB indicated that only the injury which the doctor noted was to be awarded a rating, which was something that even my commander disagreed with.  My Unit CPT was under the impression that I would be rated for my left knee, lower back, wrist, right shoulder and GERD when he sent me to MEB.  I initially did not understand why my commander was so upset about the way the board was being conducted, only one medical issue being considered, and none of the personnel going through medical board received a copy of the document indicating what the rating meant (attached) until one of the last days of the process.  It was then that we learned of the fact that 30% meant medical retirement.  I asked why I had to always state that I did not want to remain in the service and was told that it was the only way we, E-4 and below personnel being boarded, could avoid being sent to work at Walter Reed Medical Center until the army figured out what to do with us, so everyone was happy to sign and not argue about anything.  You may notices that the item marked item #1 is not even signed which is the one indicating the ratings, which we received very late in the process before being told to attend ACAP.  I had made it clear in most documents that I had other issues which contributed to my inability to run, do push-ups, and wear combat gear, which is why my commander recommended MEB, but he told me he never thought I was only going to be evaluated for only one thing.  The pain from my shoulder and lower back kept me from wearing my flak vest my left wrist operation kept me from doing push-ups and my knees from running. ”

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI.  The rating for the unfitting left knee condition is addressed below; no additional conditions are within the DoDI 6040.44 defined purview of the Board.  The low back, left wrist, right shoulder and gastroesophageal reflux disease were not identified by the MEB/PEB and are not within the DoDI 6040.44 defined purview of the Board.  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 Military Records (BCMR).

RATING COMPARISON:

Service IPEB – Dated 20011017	VA - Service Treatment Records (STR)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Knee Pain	5010-5003	10%	S/P Left Posterior Cruciate Ligament Reconstruction	5260	10%*	STR	
No Other MEB/PEB Entries within Scope	Other x 7	
Rating:  10%	Combined:  10%	
Derived from VA Rating Decision (VARD) dated 20030116 (most proximate to date of separation [DOS]).
Rating increased to 30% effective DOS on 20031216 VARD and 20030428 C&P

ANALYSIS SUMMARY:  The Board acknowledges the CI’s assertions that his disability disposition was unfair and should have included other conditions.  The DA Form 3947, MEB Proceedings, listed one condition and block 34 was checked, indicating “I agree with the board’s findings and recommendation.”  It is noted for the record that the Board has no jurisdiction to investigate or render opinions in reference to such allegations.  Redress in excess of the Board’s scope of recommendations (as noted above) must be addressed by the respective BCMR and/or the United States judiciary system.

Left Knee Condition.  The narrative summary dated 22 August 2001, 5 months prior to separation, notes the CI had a left knee injury in February 1999 when he tripped over a curb while running and landed on his knee, he felt a pop and had immediate swelling.  A magnetic resonance image showed a disrupted PCL.  He underwent PCL reconstruction surgery in August 1999.  He continued to have pain and instability.  He underwent a revision of the PCL with graft in January 2001.  In patient rehabilitation was performed for approximately 3 months without improvement in his symptoms of instability and pain.  Despite profile limitations and anti-inflammatory medications he still could not perform the requirements of his MOS.  Physical examination for the MEB revealed he was sitting comfortably with knee and hips flexed to 90 degrees.  The knee had well healed surgical scars with slight numbness around surgical sites, no varus or valgus laxity, no posterior drawer sign for PCL laxity and negative Lachman’s test for anterior cruciate ligament laxity, neurovascular exam was intact, there was normal (5/5) muscular strength in all muscular groups distally.  Mild sag sign with the knee flexed to 45 degrees (for PCL injury).  Range-of-motion (ROM) was 0-120 with pain at extreme ROMs.  X-ray showed early degenerative changes of his left knee.  A VA Compensation and Pension exam was not in evidence proximal to the date of separation.  The VA used the service treatment records for rating determinations.

The Board directs attention to its rating recommendation based on the above evidence.  The PEB used VASRD diagnostic code 5010 (arthritis due to trauma) – 5003 (degenerative arthritis) for a 10% rating.  The Board did not find a compensable ROM deficit under 5260 (leg limitation of flexion) used by the VA for a 10% rating.  The Board found satisfactory evidence of pain upon motion for a minimal 10% rating under 5010-5003.  There was no evidence of non-union, no loose motion, no locking pain and no effusion into the knee joint, for a higher rating under alternate codes.  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 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.

RECOMMENDATION:  The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20130724, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

		

SAMR-RB									

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXX, AR20140021521 (PD201301051)

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						
						         
CF: 
(  ) DoD PDBR
(  ) DVA