RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201476 SEPARATION DATE: 20021202 

BOARD DATE: 20130320 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (77F/Petroleum Supply Specialist), medically 
separated for chronic right anterior knee pain. The CI has a long history of right knee pain that 
began when she experienced a right knee patellar dislocation during a run in her Advanced 
Individual Training in 1990. She underwent long-term conservative treatment to include 
physical therapy (PT). Her Military Occupational Specialty (MOS) was also reclassified. Despite 
orthopedics evaluations, an arthroscopy and debridement of a medial plica, occupational 
therapy (OT), physical therapy (PT), crutches and a knee brace, the CI failed to meet the 
physical requirements of her MOS or meet physical fitness standards. She was issued a 
permanent L3 profile and referred for a Medical Evaluation Board (MEB). The MEB forwarded 
right anterior knee pain to the Physical Evaluation Board (PEB) as medically unacceptable IAW 
AR 40-501. The MEB also forwarded non-allergic rhinitis, history of dyspnea, deconditioning 
and obesity, myopia corrected to 20/20 vision, bilateral pes planus, and migraine headache 
conditions to the PEB as medically acceptable. The PEB adjudicated the chronic right anterior 
knee pain, rated as slight condition as unfitting, rated 10% with application of the US Army 
Physical Disability Agency (USAPDA) pain policy. The remaining conditions were determined to 
be not unfitting and not rated. The CI made no appeals and she was medically separated with a 
10% disability rating. 

 

 

CI CONTENTION: “Continued right knee 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 rated condition chronic right anterior 
knee pain, as requested for consideration, is the only condition that meets the criteria 
prescribed in DoDI 6040.44 for Board purview; and, is addressed below. 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 20020917 

VA (3 Mos. Post-Separation) – All Effective Date 20021203 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Right Anterior Knee Pain 

5099-
5003 

10% 

Status Post Plica, 
Osteoarthropathy of Right Knee 

5010 

10% 

20030225 

Non-allergic Rhinitis 

Not Unfitting 

Rhinitis 

6522 

0% 

20030225 

History of Dyspnea 

Not Unfitting 

Asthma 

6602 

30% 

20030225 

Bilateral Pes Planus 

Not Unfitting 

Bilateral Pes Planus 

5276 

0% 

20030225 

De-conditioning and Obesity 

Not Unfitting 

NO VA ENTRY 

Myopia, Corrected to 20/20 Vision 

Not Unfitting 

NO VA ENTRY 

.No Additional MEB/PEB Entries. 

Status Post Partial Hysterectomy 

7618 

30% 

20030225 

Tinnitus 

6260 

10% 

20030225 

Migraine Headaches 

8100 

10% 

20030225 

Not Service-Connected x 2 

 

Combined: 10% 

Combined: 60% 



 

 

ANALYSIS SUMMARY: The Board’s authority as defined in DoDI 6040.44, resides in evaluating 
the fairness of Disability Evaluation System fitness determinations and rating decisions for 
disability at the time of separation. The Board utilizes service and VA evidence proximal to 
separation in arriving at its recommendations and DoDI 6040.44 defines a 12-month interval for 
special consideration of post-separation evidence. Post-separation evidence is probative only 
to the extent that it reasonably reflects the disability and fitness implications at the time of 
separation. 

 

Chronic Right Anterior Knee Condition. There were two goniometric range-of-motion (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. 

 

Right Knee ROM 

(Degrees) 

NARSUM ~3.5 Mo. Pre-Sep 

VA C&P ~2.87 Mo. Post-Sep 

Flexion (140 Normal) 

130 

140 

Extension (0 Normal) 

0 

0 

Comment 

stable varus/valgus; no effusion; stable anterior 
drawer; 1A Lachman’s (1-5 mm laxity); negative 
McMurray’s and grind test; “constant knee pain” 

No limitation of motion; McMurray test, 
drawer test normal; gait normal 

§4.71a Rating 

10% 

10% 



 

The CI had a well-documented history of right knee complaints in the service treatment record 
(STR) from March 1990 through to June 2002. The CI was seen by orthopedics for the constant 
right knee pain with running in September 1993. X-rays of the right knee in 1993, 2000, and 
2001 were all negative along with magnetic resonance imaging (MRI) performed in September 
2001. The CI continued to be followed by orthopedics and was given an intra-articular steroid 
injection in July 2001. The CI was given a sick slip for use of a knee brace and then was 
reevaluated by orthopedics for an arthroscopy. She underwent a right knee diagnostic 
arthroscopy with a medial plica excision in January 2002. The commander’s statement 
documented that the CI’s physical ability to perform her MOS duties had deteriorated and that 
she required access to an elevator because she was unable to walk up and down stairs or lift 
normal loads or weights. The MEB narrative summary (NARSUM) examination 3 months prior 
to separation indicated right knee pain that was moderate and frequent. Her pain was 
exacerbated by squatting–type activities and her right knee gave out three times while walking 
down stairs. The examiner opined that the CI was not expected to improve. The physical exam 
findings are in the chart above. The CI was issued an L3 profile with restrictions of no running, 
no jumping no road marching, and no lifting greater than twenty pounds. The VA 
Compensation and Pension (C&P) examination approximately 2 months after separation 
indicated that a recent MRI demonstrated right knee degenerative joint disease (DJD) and a 


right knee X-ray revealed mild osteoarthropathy of the knee joint. The examiner further noted 
that the CI continued to have pain, stiffness, and discomfort during running, kneeling, or 
prolonged standing and that she had lost approximately 3 weeks of work because of this pain. 
The physical exam findings are in the chart above. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB coded the chronic right anterior knee pain as analogous to 5003 Arthritis, degenerative 
(hypertrophic or osteoarthritis) and rated at 10% with application of the USAPDA pain policy. 
The VA coded the right knee condition 5010 Arthritis, due to trauma, substantiated by X-ray 
findings. The C&P examination noted that mild osteoarthropathy of the knee joint on X-ray and 
right knee DJD on MRI. Neither exam indicated ROM limited to a compensable level for code 
5260 (leg, limitation of flexion) or 5261 (leg, limitation of extension). The PEB applied the 
USAPDA pain policy in its determination of the 10% rating. However, use of this policy did not 
materially affect the rating in this case and a 10% rating is obtained when utilizing the VASRD 
alone for any of the ratable exams proximate to separation. VASRD §4.71a specifies for 5003 
that “satisfactory evidence of painful motion” constitutes limitation of motion and specifies 
application of a 10% rating “for each such major joint or group of minor joints affected by 
limitation of motion” and VASRD §4.59 (Painful motion) provides an alternate justification for a 
10% rating. The right knee condition could not be reasonably rated higher than 10% using any 
exam proximate to separation or any alternate rating schema. After due deliberation, 
considering all of the evidence and mindful of VASRD §4.3 (Resolution of reasonable doubt), the 
Board concluded that there was insufficient cause to recommend a change in the PEB 
adjudication for the chronic right anterior knee pain 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 chronic right anterior knee pain condition was 
operant in this case and the condition was adjudicated independently of that policy by the 
Board. In the matter of the chronic right anterior knee pain 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 Right Anterior Knee Pain 

5099-5003 

10% 

COMBINED 

10% 



 


The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120602, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxx, 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 
xxxxxxxxxxxxxxxxxxxxxxxxxx AR20130007470 (PD201201476) 

 

 

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)