NAME:  XXXXXXXXXXXX                                                                          BRANCH OF SERVICE:   ARMY   
CASE NUMBER:  PD1200604 
SEPARATION DATE:  20030702 
BOARD DATE:  20121109    
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was a PV2/E-2 (19K/Student) medically separated for bilateral knee pain 
due  to  iliotibial  band  friction  syndrome  (IBFS).    The  CI  was  treated,  but  did  not  improve 
adequately  to  fully  perform  his  military  duties  or  meet  physical  fitness  standards.    He  was 
issued a permanent L-3 profile and underwent a Medical Evaluation Board (MEB).  The MEB 
referred him to a  Physical  Evaluation  Board  (PEB)  for  his  bilateral  IBFS.    No  other  conditions 
were listed on the DA Form 3947.  The PEB found the knee pain unfitting, and rated it 0% IAW 
the U.S. Army Physical Disability Agency (USAPDA) Policy/Guidance Memorandum #13, dated 
08  April  2002.    The  CI  accepted  the  PEB  findings,  and  was  medically  separated  with  a  0% 
disability rating.    
 
 
CI CONTENTION:  “I was told before discharge that I may want to look into surgery for both 
right and left knees which I am in constant pain every day.  But can’t afford not to work.”    
 
 
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 knee condition (bilateral IBFS) meets the criteria prescribed 
in DoDI 6040.44 for Board purview, and is 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:   
 

Condition 
Bilateral Knee Pain 
 

Army PEB – dated 20030611 

Code 

5099-5003 

 

Rating 

0% 
 

VA (No C&P Exam done, until years later) – All Effective 20030703 
Exam 
MEB* 
MEB* 

Left Knee Pain 
Right Knee Pain 

Rating 
10% 
10% 

Code 

5099-5014 
5099-5014 

Condition 

RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

↓No Additional MEB/PEB Entries↓ 

Combined:  0% 

 
Combined:  20% 

 

*VA Rating Decision (VARD) dated 20030708 was based on evidence from the Service Treatment Record, MEB, and PEB 

 
 
 
ANALYSIS SUMMARY:   
 
Bilateral knee pain, due to Iliotibial Band Friction Syndrome (IBFS).  The CI has had a long history 
of knee pain.  At his MEB evaluation performed in May 2003, he said that he has always had 
knee pain, and the knees have always caused problems.  He reported knee pain with running, 
squatting,  kneeling,  and  doing  stairs.    On  examination,  he  was  in  no  acute  distress  and  the 
knees  were  nontender  to  palpation.    He  had  negative  patellofemoral  compression,  negative 

joint line tenderness, negative varus/valgus instability, and negative effusion.  Active range-of-
motion  (ROM)  for  both  knees  was  full.    For  an  orthopedic  diagnosis,  the  May  2003  MEB 
examiner  stated:  “Bilateral  iliotibial  band  friction  syndrome,  unrelieved  with  conservative 
treatment.”  Knee ROM was apparently not measured goniometrically.  Also in May 2003, the CI 
filed a VA disability claim, but no VA Compensation and Pension (C&P) exam was done at that 
time.  His VA Rating Decision (VARD) dated 8 July 2003 was based on evidence from the service 
treatment record (STR), MEB, and PEB.  The VA rated his knees at 10% each, for a combined 
disability rating of 20%. 
 
The Board carefully reviewed all evidentiary information available, and directs attention to its 
rating recommendation based on the evidence above.  The Army PEB combined the CI’s knee 
pain into a single unfitting condition: Chronic bilateral knee pain due to IBFS.  The knee pain 
condition was coded 5099-5003 and rated at 0%.  In contrast, the VA unbundled the two knees, 
and rated each knee at 10%.  The Board evaluated whether or not it was appropriate for the 
two  knees  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 Veterans’ Administration Schedule for Rating Disabilities 

(VASRD)  §4.71a.    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  agreed  that  the  evidence  supports  a  conclusion 
that the chronic painful condition in each knee, separately, would have rendered the CI unable 
to  perform  his  required  military  duties.    Accordingly,  the  Board  recommends  a  separate 
disability rating for each knee. 
 
There  was  no  documented  limitation  of  knee  motion.    Therefore,  both  knees  are  essentially 
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 evidence of functional limitation due to painful motion of a major joint.  Although it 
was  not  specifically  documented  by  the  examiner,  the  Board  surmises that both  knees  were 
painful  to  motion.    It  is  recorded  that  the  CI  had  pain  every  time  he  runs.    After  due 
deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the 
Board recommends a rating of 10% for right knee pain, due to IBFS.  In like manner, the Board 
recommends a disability rating of 10% for left knee pain, due to IBFS.    
 
 
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 noted above, the Army 
PEB used the USAPDA pain policy for rating the bilateral knee pain condition.  The knee pain 
condition  was  adjudicated  independently  of  that  policy  by  the  Board.    In  the  matter  of  the 
bilateral  knee  pain,  the  Board  unanimously  recommends  that  each  joint  be  separately 
adjudicated as follows: an unfitting right knee condition coded 5099-5003 and rated 10%, and 
an unfitting left knee condition coded 5099-5003 and rated 10%.  These knee pain ratings are 
IAW VASRD §4.40, §4.45, §4.59, and §4.71a.  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:   

VASRD CODE 
5099-5003 
5099-5003 

COMBINED (with BLF) 

RATING 

10% 
10% 
20% 

 

UNFITTING CONDITION 

Right Knee Pain, due to Iliotibial Band Friction Syndrome 
Left Knee Pain, due to Iliotibial Band Friction Syndrome  

 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120705, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

 
 

 
 
 

 
 
 

 
 
 

 
 
 

 
 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB /  ), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for XXXXXXXXXXXXXXXXXXXXX, AR20120021958 (PD201200604) 
 
 
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 
 
 
 
CF:  
(  ) DoD PDBR 
(  ) DVA 
 

     XXXXXXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)