RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201373 SEPARATION DATE: 20021208 

BOARD DATE: 20130308 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty Soldier, PV2/E-2(74C/Record Telecommunications 
Operator Maintainer), medically separated for chronic bilateral knee pain. The CI developed 
bilateral knee pain during a field training exercise (FTX) while in basic training. She did not 
report the injury and entered advanced individual training (AIT). While in AIT, the pain 
worsened and she presented to the troop medical clinic. The CI did not improve adequately 
with treatment, including multiple profiles and anti-inflammatory drugs, to meet the physical 
requirements of her Military Occupational Specialty (MOS) or satisfy physical fitness standards. 
She was issued a permanent L3/S2 profile and referred for a Medical Evaluation Board (MEB). 
The MEB forwarded bilateral knee pain and depressive disorder, not otherwise specified (NOS), 
to the Physical Evaluation Board (PEB). The MEB forwarded no other conditions for PEB 
adjudication. The PEB adjudicated the chronic bilateral knee pain as unfitting, rated 0%, with 
application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD) and the US Army 
Physical Disability Agency (USAPDA) pain policy. The PEB adjudicated the depressive disorder, 
not otherwise specified, as not unfitting. The CI made no appeals and was medically separated 
with a 0% disability rating. 

 

 

CI CONTENTION: The CI elaborated no specific contention in her application. 

 

 

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. 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 PEB – Dated 20021029 

VA (10 Mos. Post-Separation) – All Effective Date 20021209 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Bilateral Knee 
Pain 

5099-5003 

0% 

PFS with CMP, L Knee 

5099-5024 

10% 

20030911 

PFS with CMP, R Knee 

5099-5024 

10% 

20030911 

Depressive Disorder, NOS 

Not Unfitting 

No VA Entry 

 

 

 

 

.No Additional MEB/PEB Entries. 

 

0% X 0 / Not Service-Connected x 0 

20030911 

Combined: 0% 

Combined: 20%* 



*Includes bilateral factor of 1.9%. 

 

 

 

 

 


ANALYSIS SUMMARY: 

 

Chronic Bilateral Knee Pain. The CI apparently injured her knees during a FTX while in basic 
training, but did not report the condition and was able to graduate. Her pain persisted and she 
presented while in AIT for the bilateral pain. Despite duty limitations and medications, she was 
unable to meet her duty requirements. X-rays and a bone scan were normal. She was noted to 
be worldwide assignable and deployable, but her prognosis was unclear and it was thought that 
the rigors of a military lifestyle would preclude resolution of her pain. She was diagnosed with 
patello-femoral pain syndrome (PFS) and referred to MEB. The narrative summary (NARSUM) 
dictated on 26 September 2002 and noted that the examination had been on 3 June 2002. The 
examiner noted that the knees had no swelling or erythema. Joint line tenderness was 
minimally present bilaterally. The gait was normal and range-of-motion (ROM) full. At the 
general and joint VA Compensation and Pension (C&P) examinations, both on the same day by 
the same examiner and 9 months after separation, the CI reported persistent pain with 
prolonged standing, walking, and sitting or stair climbing. She had a normal gait and walked 
briskly down the hallway without assistive devices. She was able to walk on her heels and toes 
and get on the examination table without difficulty. On examination, flexion was 135 degrees 
bilaterally without instability or signs of meniscal injury. She could fully squat. There was some 
crepitus and pain with patellar compression. Chondromalacia patella (CMP) was diagnosed. 
Painful motion was not documented. The Board first considered if the knees were separately 
unfitting conditions. It noted that both knees were profiled, cited by the commander and 
treated. Although the PEB rated the knees as a single condition utilizing the USAPDA pain 
policy, this does not imply that the knees were not separately unfitting conditions. The Board 
determined that the preponderance of evidence supports a determination that the knees were 
separately unfitting and separately ratable. There were two goniometric ROM evaluations in 
evidence, with documentation of additional ratable criteria, which the Board weighed in 
arriving at its rating recommendation; as summarized in the chart below. 

 

 

Knee ROM 

PT ~6 Mo. Pre-Sep 

VA C&P ~10 Mo. Post-Sep 

Left 

Right 

Left 

Right 

Flexion (140° Normal) 

135 

135 

135 

135 

Extension (0° Normal) 

0 

0 

0 

0 

Comment 

Noted to be normal ROM 

No comment if the flexion is 
normal or reduced 

§4.71a Rating 

0% 

0% 

0% 

0% 



 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB coded the condition 5099-5003, analogous to degenerative arthritis, and rated the knees at 
0%. The VA rated each knee separately at 10% using the code 5024, tenosynovitis, analogously, 
and citing the minimal limitation in ROM from the VA normal value of 140 degrees flexion and 
the presence of crepitation and tenderness on patellar compression. The Board noted that CI 
had a normal gait on all examinations and no restrictions in movement. The ROM was 
documented as normal on the prior to separation examination although 5 degrees less than the 
VA normal value. Regardless, this is not a compensable limitation. X-rays and a bone scan were 
normal. She could squat as well as heel and toe walk without difficulty. Crepitus and pain were 
noted on the C&P examination, but both are non-specific findings. Motion was not 
documented as painful. The Board considered all the evidence and found no route to a rating 
higher than the 0% adjudicated by the PEB. While the C&P examiner did document pain and 
crepitus, the gait was noted to be brisk and normal. In addition, the CI could fully squat and 
had no limitations getting on the examination table. There was no objective evidence for a 
functional limitation documented. While separate 0% ratings could be assigned, this provides 


no advantage to the CI. 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 bilateral 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 for rating the bilateral knee pain was operant in this case 
and the condition was adjudicated independently of that policy by the Board. In the matter of 
the 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 Bilateral Knee Pain 

5099-5003 

0% 

COMBINED 

0% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120724, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 XXXXXXXXXXXXXXXXXX, 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, AR20130006201 (PD201201373) 

 

 

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 XXXXXXXXXXXXXXXXX 

 Deputy Assistant Secretary 

 (Army Review Boards)