BVA9506479 DOCKET NO. 93-11 091 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Indianapolis, Indiana THE ISSUE Entitlement to an increased rating for patellofemoral arthrosis of the right knee with medial meniscectomy, currently evaluated as 20 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD K. E. Harrison, Associate Counsel INTRODUCTION The veteran had active military service from June 1980 to August 1982. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 1992 rating decision by the RO. In August 1992, the veteran was awarded a temporary 100 percent evaluation following knee surgery, from July 2, 1992, through September 30, 1992. After this period, his evaluation was restored to the previous 10 percent disability rating. The veteran filed a notice of disagreement and a substantive appeal in response to the rating of July 1992 and was subsequently granted a VA examination in December 1992. Based on the examination findings the RO increased the veteran's rating from 10 percent to 20 percent under Diagnostic Code 5257 in February 1993. The appeal was continued. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that his right knee condition has increased in severity and warrants an evaluation higher than 20 percent. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that a preponderance of the evidence is for the claim for increase and supports the assignment of a rating of 30 percent for the service-connected patellofemoral arthrosis of the right knee with medial meniscectomy. FINDINGS OF FACT 1. The evidence required for a proper adjudication of the issue on appeal has been obtained. 2. Patellofemoral arthrosis of the right knee is manifested by pain, crepitus, tenderness over the medial joint space, medial femoral osteophyte and over the lateral joint space. He also has tenderness over the quadriceps and over the patella tendon. 3. Severe overall knee disability is demonstrated. CONCLUSION OF LAW The criteria for the assignment of a rating of 30 percent for patellofemoral arthrosis of the right knee with medial meniscectomy are met. 38 U.S.C.A. §§ 1155, 5107(a), 7104 (West 1991); 38 C.F.R. §§ 3.321, 4.7, 4.40, 4.71 including Codes 5257, 5260, 5261 (1994) REASONS AND BASES FOR FINDINGS AND CONCLUSION Background. At the time of induction it was reported that the veteran had a right medial meniscectomy in 1973. A May 1980 entrance examination revealed that the veteran's orthopedic examination and X-ray studies were negative. Service medical records show that the veteran was seen on several occasions for various injuries to his right knee. He was hospitalized for knee pain in February 1982 and had arthroscopy which showed changes of chondromalacia. Service connection for patella femoral arthrosis, right knee, status post medial meniscectomy was granted by a rating decision of November 1982 and a 10 percent rating was assigned. The record shows that the veteran had arthroscopy of the right knee with partial meniscectomy of retained posterior third of the right medial meniscus in February 1983. The veteran had another arthroscopy of the right knee in 1992 which found right knee recurrent medial tearing; right knee Grade IV chondromalacia medial plateau and medial femoral condyle with peripheral fragmented cartilaginous surfaces medial femoral condyle; and Grade III chondromalacia/Grade IV chondromalacia patella. A VA examination of December 1992 reported that the veteran was in constant pain which was increased with prolonged ambulation. The veteran stated that he could walk a maximum of two blocks and could ambulate one half hour in the mall on a level surface. He also reported that he did not have any current locking symptoms to his knee and that he did not have any real instability to his knee where it would give out. Upon physical examination there was minimal effusion to his right knee and negative Lockman's of his right knee. He had a negative posterior drawer and a negative anterior drawer. He had tenderness over his medial joint space as well as palpable medial femoral osteophyte. He had some tenderness to palpation of his anterior lateral joint space. He had tenderness over his quadriceps and tenderness over his patella tendon. There was significant patellofemoral crepitus on his right knee and none on his left. He had a range of motion of his right knee from 10 to 115 degrees. The examiner assessed that the veteran's symptoms were most likely caused from degeneration of the right knee. X-ray studies of December 1992 showed a severe narrowing of the medial compartment of the right knee with patellofemoral degeneration and spurring of the margins of the joint. The examiner's impression was degenerative arthrosis of the right knee, primarily of the narrowed medial compartment that was status post medial meniscectomy with associated patellofemoral degenerative changes. Based on the VA examination and X-ray studies of December 1992, the RO increased the veteran's rating to 20 percent in February 1993. Analysis. The current 20 percent rating is in effect under Diagnostic Code 5257. This Code provides that a 10 percent rating is warranted when there is a slight knee impairment with recurrent subluxation or lateral instability. A 20 percent is warranted for a moderate disability and a 30 percent for a severe disability. 38 C.F.R. § 4.71, Code 5257 (1994). To warrant a 30 percent rating under limitation of motion the veteran must have flexion limited to 15 degrees or extension limited to 20 degrees. 38 C.F.R. § 4.71, Codes 5260, 5261 (1994). The evidence of record shows an impairment of the right knee that warrants a 30 percent disability rating. The veteran has presented evidence showing that he has a severe knee disability. In fact, at the most recent VA examination, X-ray studies showed severe degenerative changes. In addition, the veteran described what the Board would characterize as severe functional limitation. Accordingly, the Board finds that the veteran's current symptomatology does warrant the assignment of a 30 percent rating. The Board finds that a preponderance of the evidence is for the claim for an increased rating for patellofemoral arthrosis of the right knee with medial meniscectomy. ORDER An increased rating of 30 percent for the service-connected patellofemoral arthrosis of the right knee with medial meniscectomy is granted, subject to the regulations controlling disbursement of VA monetary benefits. STEPHEN L. WILKINS Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.