RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXX CASE: PD1201229 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130410 

SEPARATION DATE: 20021030 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (68F, Aircraft Electrician) medically separated 
for chronic low back pain (LBP) and right knee pain. The CI received back injuries in February 
2001 as she was leaving a morning formation and was struck by a HUMVEE. She was treated 
with non-steroidal anti-inflammatories and profiling without improvement. The CI also had a 
history of right knee pain which dates to February 1997. She sustained a twisting injury during 
training. She was treated conservatively with physical therapy, and non-steroidal anti-
inflammatories without relief. Her conditions could not be adequately rehabilitated to meet 
the physical requirements of her Military Occupational Specialty (MOS) or satisfy physical 
fitness standards. She was issued a permanent L4 profile and referred for a Medical Evaluation 
Board (MEB). The back and right knee conditions were characterized as medically unacceptable 
and forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions 
were submitted by the MEB. The Informal PEB (IPEB) adjudicated chronic LBP and right knee 
pain as unfitting, rated 10% and 0% respectively, with likely application of the US Army Physical 
Disability Agency (USAPDA) pain policy. The CI made no appeals, and was medically separated 
with a 10% rating. 

 

 

CI CONTENTION: “Mrs. G--- was medically discharged from Army with lower back and knee 
issues; both issues are the result of documented on-duty accidents. When she went for her 
initial physical for determination of rating, performing doctor dedicated less than five to ten 
minutes for this physical and it was the last of appointment of the day. The appointment was 
rushed and the doctor apathetic at best. Mrs. G--- appealed the original rating but did not 
receive an increase. Mrs. G--- has ongoing back and knee issues that take away from bother her 
everyday activities, hobbies, and interests. Mrs. G--- has sleeping issues due to back pain in 
which she is unable to sleep for a continuous eight hours. She also takes over the counter pain 
medication such as ibuprofen in conjunction with prescribed anti-inflammatories and muscle 
relaxants (when prescribed). She also uses heating pad and hot baths to relieve pain. Car 
travel is also difficult on Mrs. G---’s back and knees as the extended sitting makes car travel 
after a couple of hours difficult. Mrs. G--- has sought doctor care for her back and knee 
problems.” 

 

 

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 ratings for the unfitting LBP and right knee 
pain conditions are addressed below. No additional conditions are 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 Army Board for Correction of Military Records. 

 


 

 

RATING COMPARISON: 

 

Army PEB – dated 20020730 

VA - (10 mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Low Back Pain 

5299-5295 

10% 

Thoracic Degenerative Disc 
Disease w/Mechanical Back Pain 

5291-5010 

10% 

20030716 

Right Knee Pain 

5099-5003 

0% 

Right Knee Patellofemoral 
Syndrome 

5299-5257 

*10% 

20030716 

No Additional MEB/PEB Entries 

Other x 1 

20030716 

Combined: 10% 

Combined: *20% 



*Per VARD dated 20041025, right knee condition rating was changed to 10% with combined rating of 20% effective 20021101 

 

 

ANALYSIS SUMMARY: 

 

Low Back Pain (LBP). In February 2001, the CI injured her back when she was struck by a 
vehicle. Magnetic resonance imaging (MRI) in December 2001 showed degenerative changes at 
T10-T11 and T11-T12, without evidence of bulge. Conservative treatment did not relieve the 
pain, so an MEB was initiated. At the MEB orthopedics exam performed on 16 May 2002, there 
was tenderness to palpation (TTP) from T11 to L4, bilaterally. There was no obvious deformity. 
She could toe and heel walk. She could forward flex to 3 inches from the ground. Neurological 
exam showed normal motor strength in muscle groups of the lower extremities, with the 
exception of bilateral mild weakness in extensor halluces longus muscles. Sensation was intact. 

 

At the VA Compensation and Pension (C&P) exam, performed 9 months after separation, the CI 
reported pain with prolonged bending or pulling. Rarely, the discomfort would radiate up into 
her neck and shoulders. There were no radicular symptoms. On physical exam, the gait was 
normal. Lumbar range-of-motion (ROM) was normal. Toe and heel walking were normal. 
Neurological exam was normal. Straight leg raise (SLR) was negative. The Board carefully 
reviewed all evidentiary information available, and directs attention to its rating 
recommendation based on the above evidence. The Army PEB and the VA chose different 
coding options for the back pain condition, but both assigned a rating of 10%. The Veterans’ 
Administration Schedule for Rating Disabilities (VASRD) coding and rating standards for the 
spine, which were in effect at the time of the CI’s separation, were changed in September 2003. 
The older standards were based on the rater’s opinion regarding degree of severity, whereas 
current standards specify certain rating thresholds, with measured degrees of ROM 
impairment. IAW DoDI 6040.44, the Board must use the VASRD coding and rating standards 
which were in effect at the time of the CI’s separation from service. 

 

Based on a thorough review of the evidence in the service treatment record (STR), the Board 
determined that IAW VASRD §4.71a, the CI’s LBP condition was best described as “slight.” 
There was insufficient evidence to support classifying the condition as “moderate” or “severe.” 
After due deliberation, the Board determined that a separation disability rating of 10% was 
warranted. The Board tried to find a path to a rating higher than 10%, using other codes which 
could be applied to the LBP condition. The other VASRD codes that were considered did not 
result in a rating higher than 10%, since the STR did not show sufficient evidence of a disabling 
lumbar spine abnormality which would justify a rating higher than 10%. The Board also 
considered the matter of peripheral neuropathy. After reviewing all the information in the STR, 
there was insufficient evidence of a clinically significant neuropathy that interfered with 
satisfactory performance of military duties. Therefore, there was no unfitting radiculopathy 


present at the time of separation from service. 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 LBP condition. 

 

Right Knee Pain. In February 1997, the CI injured her right knee during training. Conservative 
treatment did not completely relieve the pain. An MRI in July 2000 revealed retropatellar 
cartilage changes consistent with Grade I chondromalacia. The MEB orthopedics examination 
of the right knee on 16 May 2002, revealed no effusion, no laxity, no crepitus, no tenderness, 
and no obvious deformity. Right knee ROM was from zero to 140 degrees. At the C&P exam, 9 
months after separation, the CI reported intermittent symptoms. Her knee sometimes felt stiff 
after prolonged sitting. She denied locking, catching, or swelling. Exam of the right knee 
revealed full ROM. There was no effusion, but there was mild TTP around the medial 
patellofemoral joints. There was no instability. 

 

Once again, the Board carefully reviewed all the available evidence. The PEB coded the knee 
condition as 5099-5003 (Analogous to degenerative arthritis), and assigned a rating of 0%. The 
Board noted the minimal exam findings of the right knee. After due deliberation, the Board 
determined that a separation disability rating of 0% was warranted. The Board tried to find a 
path to a rating higher than 0%, using other codes which could be applied to the knee 
condition. The other VASRD codes that were considered did not result in a rating higher than 
0%, since the STR did not show sufficient evidence of a disabling joint abnormality which would 
justify a rating higher than 0%. 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 right 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. As discussed above, PEB 
reliance on the USAPDA pain policy may have been operant in this case and the condition was 
adjudicated independently of that policy instruction by the Board. In the matter of the LBP, and 
the right knee pain conditions, 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 

Low Back Pain 

5299-5295 

10% 

Right knee pain 

5099-5003 

0% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120716, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 


 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxxxxxx, AR20130009494 (PD201201229) 

 

 

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 xxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)