RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201151 SEPARATION DATE: 20020215 

BOARD DATE: 20130307 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an Army Reservist; SSG/E-6 (73C, Finance) medically separated for 
low back pain (LBP) and right knee pain. The CI was treated, but did not improve adequately to 
fully perform her military duties or meet physical fitness standards. The CI was issued a 
permanent profile and underwent a Medical Evaluation Board (MEB). The MEB found her low 
back condition and her right knee condition medically unacceptable IAW AR 40-501, and 
referred her to a Physical Evaluation Board (PEB). No other conditions were listed on DA Form 
3947. The PEB found both the back pain and the right knee pain unfitting, and rated them 10% 
and 0% respectively, with application of the Veterans Administration Schedule for Rating 
Disabilities (VASRD). The CI made no appeals, and was medically separated with a 10% 
disability rating. 

 

 

CI’s CONTENTION: “A 10% rating should not have put me out of the military at the time the 
board came back with a finding. I was working as a 73C Finance MOS in a reserve unit. I also 
lost my civilian position as a military tech. The findings found me discharged from the Reserves 
after serving from 1984-2002 (18 years). Yet the document said I could serve in the VA National 
Guard. And I lost my Unit Administrator position of: Unit Administrator, which meant when I 
got discharged I lost both incomes.” 

 

 

SCOPE OF REVIEW: The Board’s scope of review as defined in DoDI 6040.44, 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 back condition (lumbar spinal stenosis) and the unfitting 
right knee condition (patellofemoral pain syndrome) meet the criteria prescribed in DoDI 
6040.44, and are accordingly addressed below. No other conditions are 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: 

 

Service IPEB – Dated 20011128 

VA* (3 Yrs Post-Separation) – Effective 20050304 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Back Pain 

5299-5295 

10% 

Lumbar Strain 

5237 

20%** 

20050329 

Right Knee Pain 

5299-5003 

0% 

Right Knee Condition 

5260 

NSC 

20050329 

No Additional MEB/PEB Entries 

Right Shoulder Injury 

5201 

20% 

20050329 

Cervical Strain 

5237 

20% 

20050329 

Not Service-Connected x 13 

20050329 

Combined: 10% 

Combined: 50% 



 * Derived from VA Rating Decision 20050706 

 **Initially rated 10% 

 

 

ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed in the CI’s application 
regarding the significant impairment that her disability has on her quality of life. The Board 


wishes to clarify that it is subject to the same laws for disability entitlements as those under 
which the Disability Evaluation System (DES) operates. The Board’s authority resides in 
evaluating the fairness of DES fitness and rating determinations at the time of separation. The 
Board has neither the jurisdiction nor authority to scrutinize or render opinions in reference to 
alleged improprieties in the disposition of a case. The Board’s role is confined to the review of 
medical records and all evidence at hand to assess the fairness of PEB rating determinations, 
compared to standards in the VASRD, based on severity at the time of separation. 

 

Low Back Pain (LBP). The CI has a long history of LBP. In 1991 while in Kuwait, she injured her 
back in a motor vehicle accident. After her tour of active duty ended, she filed a claim with the 
VA. The injury was determined to be service-connected for residuals of lumbosacral strain in a 
VA Rating Decision (VARD), dated 31 January 1994. Then in 1999, the CI reinjured her back 
when she slipped and fell on some ice while walking down a hill in Germany. Over several 
months, many different treatment options were offered for back pain including: exercises; 
nonsteroidal anti-inflammatory drugs (NSAIDs); spinal stabilization program; physical therapy 
(PT); and epidural steroids. However, in spite of treatment her LBP persisted and an MEB was 
initiated. 

 

The MEB narrative summary (NARSUM) was dictated on 26 July 2001. At that exam, the CI 
reported that her back was painful almost all the time. She said that her LBP affected her 
walking, bending, kneeling, sleeping, stair-climbing, and rising from a chair. Range-of-motion 
(ROM) testing, indicated that the CI was able to flex her back until fingers reached mid-calf, 
approximately two feet from the floor. Right and left lateral bending caused pain. Right and 
left torsion caused pain. She rated her LBP at 56 out of 100. On muscle testing (performed by 
PT), motor strength was normal in both lower extremities. Deep tendon reflexes were normal, 
and straight leg raise was negative. Review of her X-rays showed a small spinal canal with 
progressive degenerative changes, resulting in moderate to severe lumbar spinal stenosis. 

 

As noted above, the CI was medically separated in February 2002. Three years later, she had a 
VA compensation and pension (C&P) exam. At that time, the CI was in school, having LBP every 
day. The pain was non-radiating, and she described tightness of the muscles associated with 
spasms in the lower back. During the exam, there was some tenderness, but no atrophy, motor 
deficits, sensory deficits, or neurological sequelae. Lumbar ROM was tested and measured. 
Forward flexion was 60 degrees, and lumbar extension was 10 degrees. 

 

The Board carefully reviewed all evidentiary information available, and directs attention to its 
rating recommendation based on the above evidence. The PEB coded the back condition as 
5299-5295 (condition analogous to lumbosacral strain). The July 2001 MEB exam documented 
that there was some loss of spinal motion, during flexion the CI brought her fingertips to the 
mid-calf region, approximately two feet from floor. After consideration of the clinical 
examinations noted above, the Board determined that the July 2001 MEB exam had greater 
probative value since it was conducted just 29 weeks prior to separation. The VA C&P exam 
was done 37 months (over 3 years) after separation. The Board can use VA evidence proximal 
to separation in arriving at its recommendations; and, DoDI 6040.44 defines a 12-month 
interval for special consideration to post-separation evidence. Post-separation evidence is 
probative only to the extent that it reasonably reflects the disability and fitness implications at 
separation. The Board determined that 37 months was too long. Therefore, due to its low 
probative value, the clinical data from the March 2005 C&P exam was weighted less heavily by 
the Board in arriving at its rating recommendation. 

 

The VASRD coding and rating standards for the spine, which were in effect at the time of 
separation, were modified in September 2002, and then were changed again in September 
2003. The past 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. After reviewing all the evidence, the 
Board unanimously agreed that the CI’s low back condition was best described as “slight.” 
There was insufficient evidence in the treatment record to support classifying her LBP condition 
as “moderate” or “severe.” 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. The CI injured her right knee in 1999. It was initially treated as a sprain, but 
later she was diagnosed with patellofemoral pain syndrome (PFPS). At the July 2001 MEB 
exam, she complained of burning pain at the right kneecap. Right knee flexion was 115 degrees 
(normal is 140 degrees), compared to her left knee flexion which was 120 degrees (normal is 
140 degrees). 

 

The Board carefully reviewed all evidentiary information available. The right knee was non-
compensable based on the VASRD §4.71a diagnostic 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 
right knee condition. 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 a significant 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 
unanimously recommends a disability separation rating of 10% 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. In the matter of the LBP 
condition, and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB 
adjudication. In the matter of the right knee condition, and IAW VASRD §4.40, §4.45, §4.59, 
and §4.71a; the Board unanimously recommends a disability rating of 10%, coded 5299-5260. 
There were no other conditions within the Board’s scope of review for consideration. 

 

 

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

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Back Pain 

5299-5295 

10% 

Patellofemoral Pain Syndrome, Right Knee 

5299-5260 

10% 

COMBINED 

20% 



 

 


 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120707, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxxx, 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 xxxxxxxxxxxxxxxxxxxxxx, AR20130006246 (PD201201151) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)