RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200930 SEPARATION DATE: 20030801 

BOARD DATE: 20130328 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty CPL/E-4 (71L/Postal Operator) medically 
separated for chronic bilateral knee pain. He was treated, but did not improve adequately 
to fully perform his military duties or meet physical fitness standards. He was issued a 
permanent L3 profile and underwent a Medical Evaluation Board (MEB). The MEB found 
his knee condition medically unacceptable IAW AR 40-501, and referred him to a Physical 
Evaluation Board (PEB). Three other conditions (hypertension, gastro-esophageal reflux 
disease [GERD], and ganglion cyst right wrist) were listed on DA Form 3947 as “not 
disqualifying.” The Physical Evaluation Board (PEB) found the bilateral knee pain unfitting, 
and rated it 10%, IAW the Veterans Affairs Schedule for Rating Disabilities (VASRD). The 
other three conditions were all adjudicated as “not disqualifying.” The CI made no appeals, 
and was medically separated with 10% disability. 

 

 

CI’s CONTENTION: The CI writes: “Sleep Apnea, Knees, Wrist, Hearing” [sic] 

 

 

SCOPE OF REVIEW: The Board’s scope of 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 unfitting knee 
condition (chronic bilateral knee pain secondary to osteoarthritis) and the ganglion cyst 
right wrist meet the criteria prescribed in DoDI 6040.44, and are accordingly addressed 
below. Sleep apnea and hearing are not within the Board’s purview. Any condition 
outside the Board’s defined scope of review may be eligible for future consideration by the 
Army Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Army PEB – dated 20030507 

VA (4 mos. Post-Sep) – All Effective 20030802 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Bilateral Knee Pain 

5010 

10% 

Osteoarthritis Left Knee 

5260-5003 

10% 

20031222 

Osteoarthritis Right Knee 

5260-5003 

10% 

20031222 

Hypertension 

Not Unfitting 

Hypertension 

7101 

10% 

20031222 

GERD 

Not Unfitting 

GERD 

7346 

10% 

20031222 

Cyst, Right Wrist 

Not Unfitting 

Cyst, Right Wrist 

8515-5215 

NSC 

20031222 

.No Additional MEB/PEB Entries. 

Tinnitus 

6260 

10% 

20031222 

0% x 1 / Not Service Connected x 1 

20031222 

Combined: 10% 

Combined: 40% 



 

 

ANALYSIS SUMMARY: 

 

Bilateral Knee Pain. The CI has a long history of knee pain. In May 1991 while deployed to 
Saudi Arabia, he injured his right knee when he fell into a tank trail. He had arthroscopic 
surgery on the right knee in 1996. In addition, he has had chronic problems with his left 


knee as well. Many treatment options were tried, but in spite of treatment his knee pain 
persisted. X-rays in August 2002 showed evidence of degenerative joint disease (DJD) of 
both knees. He was issued a permanent L3 profile in February 2003, and an MEB was 
initiated. His MEB clinical evaluation was on 4 March 2003. Examination of the knees 
revealed tenderness to palpation (TTP), and positive retropatellar grind. The McMurray’s 
test was negative, and there was no clinical evidence of joint laxity or edema. On 12 March 
2003, range-of-motion (ROM) testing was done by physical therapy (PT) and is summarized 
in the chart below. In December 2003, the CI had a VA Compensation and Pension (C&P) 
exam. There was crepitus of the right knee, but both knees were negative for any redness, 
swelling, or instability. Knee ROM was stated as “full.” There was pain on extremes of 
motion. The CI’s knee ROM is summarized below. 

 

Knee ROM 

PT – 4½ mos. Pre-Sep 

(20030312) 

C&P – 4½ mos. Post-Sep 

(20031222) 

Left 

Right 

Left 

Right 

Flexion (140° is normal) 

130° 

125° 

“Full” 

“Full” 

Extension (0° is normal) 

0° 

0° 

“Full” 

“Full” 

Comment 

Pain (?) 

Pain 

Pain 

Pain 

§4.71a Rating 

10%* 

10%* 

10%* 



 *10% based on VASRD §4.40 (Functional loss), §4.45 (The joints), and §4.59 (Painful motion) 

 

The Board carefully reviewed all of the evidentiary information available. The PEB 
combined the two chronic knee pain problems into a single unfitting condition: “Chronic 
bilateral knee pain secondary to osteoarthritis.” The condition was coded 5010 and rated 
at 10%. The April 2004 VA Rating Decision unbundled the two knee conditions, and 
assigned a rating of 10% to each joint, resulting in a combined rating of 20%. The Board 
evaluated whether or not it was appropriate for the two knee problems to be “bundled” 
together. The Board must determine if the PEB’s approach of combining the conditions 
under a single rating was justified in lieu of separate ratings. The Board must apply 
separate codes and ratings in its recommendations if compensable ratings for each condition are achieved IAW the VASRD. If the Board judges that two or more separate 
ratings are warranted, however, it must satisfy the requirement that each ‘unbundled’ 
condition was separately unfitting. After due deliberation, the Board determined by 
majority decision that the evidence supports a conclusion that either of the chronic knee 
conditions, separately, would have rendered the CI unable to perform his required military 
duties. Accordingly, the Board recommends a separate disability rating for each of the two 
knees. 

 

Using data in the treatment record, both knees were essentially non-compensable based 
on VASRD §4.71a codes for loss of knee motion (5260 and 5261). However; IAW VASRD 
§4.40, §4.45, and §4.59; a 10% rating is warranted when there is satisfactory evidence of 
functional limitation due to painful motion of a major joint. The Board tried to find a path 
to a rating higher than 10%, using other codes which could be applied to the knees. The 
other VASRD codes that were considered did not result in a rating higher than 10%, since 
the treatment record did not show evidence of ankylosis, malunion, or any other 
significantly disabling joint abnormality which would justify a rating higher than 10%. 

 

After due deliberation, considering all of the evidence and mindful of VASRD §4.3 
(reasonable doubt), the Board recommends by majority decision (2:1 vote) a rating of 10% 
for the chronic right knee pain, IAW VASRD §4.40, §4.45, §4.59, and §4.71a. In like 
manner, the Board recommends by majority decision (2:1 vote) a rating of 10% for the 
chronic left knee pain, IAW VASRD §4.40, §4.45, §4.59, and §4.71a. 

 

Right Wrist Condition. Ganglion cyst of the right wrist was adjudicated by the Army PEB as 
not unfitting. The Board’s main charge is to assess the fairness of the PEB’s fitness 


determination. The Board’s threshold for countering Service fitness determinations is 
higher than the VASRD §4.3 (reasonable doubt) standard used for its rating 
recommendations, but remains adherent to the DoDI 6040.44 “fair and equitable” 
standard. The right wrist condition was not profiled, implicated in the commander’s 
statement, or judged to fail retention standards. This condition was reviewed by the 
action officer and considered by the Board. There was no evidence in the record that this 
condition significantly interfered with duty performance. After due deliberation in 
consideration of the preponderance of the evidence, the Board concluded that there was 
insufficient cause to recommend a change in the PEB fitness determination for the 
contended wrist 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 chronic right knee pain, the Board 
recommends by majority decision (2:1 vote) a disability rating of 10%, coded 5010-5260, 
IAW VASRD §4.40, §4.45, §4.59 and §4.71a. The single voter for dissent did not elect to 
submit a minority opinion. In the matter of the chronic left knee pain, the Board 
recommends by majority decision (2:1 vote) a disability rating of 10%, coded 5003-5260 
IAW VASRD §4.40, §4.45, §4.59 and §4.71a. The single voter for dissent did not elect to 
submit a minority opinion. In the matter of the right wrist condition, the Board 
unanimously recommends no change from the PEB determination as not unfitting. 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 

Chronic right knee pain 

5010-5260 

10% 

Chronic left knee pain 

5003-5260 

10% 

COMBINED (with BLF) 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120603, 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 / xxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxx, AR20130008772 (PD201200930) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)