RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201001 SEPARATION DATE: 20020909 

BOARD DATE: 20130206 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SSGT/E-6 (92A30/Automated Logistics Specialist), 
medically separated for bilateral knee pain with retropatellar pain syndrome and infrapatellar 
tendinitis. The CI did not improve adequately with treatment by physical therapy and 
medication to meet the physical requirements of his Military Occupational Specialty (MOS) or 
to satisfy physical fitness standards. He was issued a permanent L3 profile and referred for a 
Medical Evaluation Board (MEB). The MEB forwarded left knee retropatellar pain syndrome 
with left knee patellar tendonitis as the only condition for Physical Evaluation Board (PEB) 
adjudication. The PEB adjudicated the bilateral knee condition as unfitting, rated 0% with 
application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) and likely the US 
Army Physical Disability Agency (USAPDA) pain policy. The CI made no appeals, and was 
medically separated with a 0% disability rating. 

 

 

CI CONTENTION: “Patellar tendonitis/Knee Pain – condition continues to cause chronic pain & 
limits mobility and ability to interact with my daughter’s athletic support. I would like to be 
more active but I can’t due to my condition. Back Sprain – limits mobility due to chronic pain 
and limits ability to participate in athletic training with my daughter. I also want to umpire 
softball games but I cannot due to the pain in my back after standing or crouching. Positive TB 
test was denied. I received zero percent for hallux valgus and I continue to have right foot 
pain.” 

 

 

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 bilateral knee condition requested for 
consideration meets the criteria prescribed in DoDI 6040.44 for Board purview, and is 
accordingly addressed below. The other requested back sprain, positive TB test and hallux 
valgus are not 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 20020801 

VA (1 Mos. Pre -Separation) – All Effective Date 20020910 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Bilateral Knee Pain with 
Retropatellar Pain Syndrome 

5024 

0% 

Chondromalacia Patellae and 
Patellar Tendonitis, Rt Knee 

5299-5260 

10% 

20020815 

Chondromalacia Patellae and 
Patellar Tendonitis, Lt Knee 

5299-5260 

10% 

20020815 

No Additional MEB/PEB Entries 

Residuals Low Back Sprain 

5299-5295 

10% 

20020815 

0% X 2 / Not Service-Connected x 1 

20020815 

Combined: 0% 

Combined: 30% 



 


ANALYSIS SUMMARY: The Board acknowledges the CI's contention suggesting that ratings 
should have been conferred for other conditions documented at the time of separation and for 
conditions not diagnosed while in the service (but later determined to be service-connected by 
the VA). While the Disability Evaluation System considers all of the member's medical 
conditions, compensation can only be offered for those medical conditions that cut short a 
member’s career, and then only to the degree of severity present at the time of final 
disposition. The Department of Veterans Affairs, however, is empowered to compensate 
service-connected conditions and to periodically re-evaluate said conditions for the purpose of 
adjusting the Veteran’s disability rating should the degree of impairment vary over time. 

 

Bilateral Knee Pain with Retropatellar Pain Syndrome Condition. The PEB rated bilateral knee 
pain with retropatellar pain condition under the single analogous 5024 (Tenosynovitis) code. 
This coding approach is countenanced by AR 635-40 (B.24 f.), but IAW DoDI 6040.44 the Board 
must apply only VASRD guidance to its recommendation. The Board must therefore apply 
separate codes and ratings in its recommendations if compensable ratings for each joint are 
achieved IAW VASRD §4.71a. If the Board judges that two or more separate ratings are 
warranted in such cases, however, it must satisfy the requirement that each “unbundled” 
condition was reasonably unfitting. Since §4.71a criteria are met for separate joint ratings in this 
case, the Board is pursuing separate rating and fitness evaluations as follows. 

 

The CI was first evaluated for non-traumatic bilateral knee pain in February 2001 and was 
referred for orthopedic evaluation. He reported bilateral knee pain and was diagnosed with left 
infrapatellar tendinitis. Despite temporary profiles and physical therapy the CI was judged to be 
unable to fully resume the duties of his MOS and MEB proceedings were initiated. The 
permanent profile limitations, for left patellar tendonitis, included no running, jumping, 
climbing or squatting. The commander’s statement documented the CI was working in his 
MOS, but was unable to physically train and lead soldiers due to his physical condition. The 
narrative summary indicated bilateral knee symptoms, with left greater than right. The Board 
adjudged that both lower extremity conditions were reasonably unfitting. At the MEB exam 2 
months prior to separation, the CI reported continued bilateral knee pain, left greater than 
right. Orthopedic MEB physical exam noted bilateral mild patellar tendon tenderness to 
palpation of the left knee greater than the right and a positive quadriceps inhibition test for 
patellofemoral syndrome left greater than right. Range-of-motion (ROM) was normal (0-140 
degrees) bilaterally. Left and right X-rays were normal and magnetic resonance imaging of the 
left knee revealed tendinitis. Orthopedic diagnosis was left knee pain syndrome with left knee 
patellar tendinitis. The PEB disability description was “bilateral knee pain with retropatellar 
pain syndrome and infrapatellar tendinitis,…rated as tenosynovitis without loss of joint motion 
or joint instability.” At the VA Compensation and Pension exam a month prior to separation, 
the CI reported pain worse with running, squatting, sports and kneeling. Physical exam 
indicated tenderness to ballottement to right and left patella and 2+ crepitus of the right and 
left knees. ROM was normal (0-140 degrees) bilaterally. The diagnosis was bilateral 
chondromalacia patellae and patellar tendonitis, left knee. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB and the VA rated this condition differently on different exam findings. The PEB combined 
the two conditions of right and left knee pain under 5024 at 0% and stated “tenosynovitis 
without loss of joint motion or joint instability.” The VA rated each knee separately code 5299-
5260 at 10% (Analogous to limitation of flexion) for pain and the cited diagnoses. The Board 
agreed that the MEB exam and treatment records supported conceding painful motion IAW 
VASRD §4.59 (Painful motion) of each joint with consideration of §4.40 (Functional loss). 
Coding analogous to osteomalacia (5014) or to 5003 (Patellofemoral syndrome) was 
considered; however, no rating schema was greater than 10% for each knee. The Board 
considered analogous coding to 5014 predominate for the right knee as there was no evidence 
of tendonitis of the right knee (only the retropatellar pain syndrome). After due deliberation, 


considering all of the evidence and mindful of VASRD§ 4.3 (Resolution of reasonable doubt), 4.7 
(Higher of two evaluations) and §4.45 (The joints); the Board recommends that the bilateral 
knee condition be rated for two separate unfitting conditions as follows: left knee coded 5024 
at 10% for left knee pain with retropatellar pain syndrome and infrapatellar tendinitis and right 
knee coded 5299-5014 at 10% for right knee pain with retropatellar pain syndrome. 

 

 

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 bilateral knee pain was likely operant in this case 
and the condition was adjudicated independently of that guidance by the Board. In the matter 
of the bilateral knee pain with retropatellar pain syndrome and infrapatellar tendinitis 
condition, the Board unanimously recommends that it be rated for two separate unfitting 
conditions as follows: left knee pain with retropatellar pain syndrome and infrapatellar 
tendinitis coded 5024 and rated 10%; and right knee pain with retropatellar pain syndrome 
coded 5299-5014 and rated 10%; and; both IAW VASRD §4.71a. There were no other 
conditions within the Board’s scope of review for consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of his prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Left Knee Pain with Retropatellar Pain Syndrome and Infrapatellar 
Tendinitis 

5024 

10% 

Right Knee Pain with Retropatellar Pain Syndrome 

5299-5014 

10% 

COMBINED (w/ BLF) 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120615, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

 XXXXXXXXXXXXXXXXXXX, 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 XXXXXXXXXXXXXXXX, AR20130003888 (PD201201001) 

 

 

1. 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 to modify the individual’s disability rating to 20% 
without recharacterization of the individual’s separation. This decision is final. 

 

2. I direct that all the Department of the Army records of the individual concerned be 
corrected accordingly no later than 120 days from the date of this memorandum. 

 

3. I request that a copy of the corrections and any related correspondence be provided 
to the individual concerned, counsel (if any), any Members of Congress who have 
shown interest, and to the Army Review Boards Agency with a copy of this 
memorandum without enclosures. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl XXXXXXXXXXXXXXXXXX 

 Deputy Assistant Secretary 

 (Army Review Boards)