RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200963 SEPARATION DATE: 20030430 

BOARD DATE: 20130215 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty PFC/E-3 (11B/Infantryman), medically separated for 
chronic left knee pain due to patellofemoral stress syndrome (PFS) that could not be 
adequately rehabilitated for the CI to meet the physical requirements of his Military 
Occupational Specialty (MOS) or satisfy physical fitness standards. He was issued a permanent 
L3 profile and referred for a Medical Evaluation Board (MEB). The MEB forwarded chronic knee 
pain to the Physical Evaluation Board (PEB) as the sole condition for adjudication. The PEB 
adjudicated the chronic left 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 was 
medically separated with a 10% disability rating. 

 

 

CI CONTENTION: “10% left knee Patella Flamoral (sic) Syndrome. 10% Mental Health Bi-polar 
Depression. PTSD argumental.” 

 

 

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 chronic 
left knee pain is the only condition within the Board’s purview. 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 IPEB – Dated 20030314 

VA (2 Mos. Post-Separation) – All Effective Date 20030501 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Left Knee Pain 

5099-5003 

10% 

Patellofemoral pain syndrome 

5299-5260 

10% 

STR 

.No Additional MEB/PEB Entries. 

Not Service-Connected x 15299-5260 

STR 

Combined: 10% 

Combined: 10%* 



*The 20100428 VARD added depression (9434) at 10%, effective 20090324, increasing overall combined rating to 20%. 

 

 

ANALYSIS SUMMARY: 

 

Chronic Left Knee Pain Condition: The CI first developed left knee pain after jogging in his early 
teenage years. At age 17, accession was not recommended, but in 1998 he was cleared for 
accession after a second orthopedic examination. During his first period of active service, he 
was seen twice in August 1998 for left knee pain. He was next seen in February 2002, a little 
over 3 months after returning to active duty. He was thought to have patello-femoral pain 
syndrome (PFPS) and treated conservatively. Over the next year, he was managed with 
medications, duty modification and physical therapy without improvement adequate for full 
duty. X-rays on 22 August 2002 and 24 September 2002 were normal. Magnetic Resonance 
Imaging (MRI) of left knee on 17 October 2002 was normal other than a small knee effusion. At 
the MEB evaluation on 10 January 2003, the CI reported he used a knee brace. In the narrative 


summary (NARSUM), accomplished the same day, the examiner noted tenderness and crepitus 
with motion. There was no instability. A mildly antalgic gait was noted on the NARSUM, but 
recorded as normal on the DD Form 2807. Range-of-motion (ROM) of knees was noted as zero 
degrees of extension (normal) and 120 degrees of flexion bilaterally (122 right and 118 left) on 
the DD 2807. The NARSUM documented “full range of motion of 90 degrees in flexion of the 
left knee. Extension is to about 5 degrees.” Provocative tests for instability, meniscal irritation 
and chondromalacia were normal. Strength was normal. The VA rated the knee based on the 
service treatment records (STRs). At a VA clinical visit 4 months after separation, the CI 
reported that he was working as a security guard and also cleared brush. The action officer 
opined that this is not consistent with a significant gait abnormality. The examiner documented 
an absence of atrophy and that the sensory, motor and reflex examinations were normal, but 
made no comment on gait. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the chronic left knee pain 10%, coded 5099-5003, analogous to degenerative 
arthritis, with application of the USAPDA pain policy. The VA also rated the knee condition at 
10%, but coded it 5299-5260, analogous to limitation in flexion. The Board considered the 
diagnostic codes available for the knee. None provided a route to a higher rating than the 10% 
adjudicated for the left knee by the PEB. 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 left knee pain 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 chronic left knee pain was operant in this case 
and the condition was adjudicated independently of that policy by the Board. In the matter of 
the chronic left knee pain 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 

VASRD CODE 

RATING 

Chronic Left Knee Pain 

5099-5003 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120622, 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 / xxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxxxxxx, AR20130005537 (PD201200963) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)