RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

 

                               BRANCH OF SERVICE:  ARMY 
           SEPARATION DATE:  20020831 

 
NAME:  XXXXXXXXXXXXXXXXXX 
CASE NUMBER:  PD1200616                             
BOARD DATE:  20121030          
 
 
SUMMARY  OF  CASE:  Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty SPC/E-4 (31R/Radio Operator) medically separated 
for a right knee condition.  She injured her knee in basic training in 2000, and was ultimately 
diagnosed with retropatellar pain syndrome (RPS).  She suffered persistent pain which did not 
improve adequately with conservative management to meet the physical requirements of her 
Military  Occupational  Specialty  (MOS)  or  satisfy  physical  fitness  standards. 
  She  was 
consequently issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB).  
The condition was forwarded to the Physical Evaluation Board (PEB) as medically unacceptable 
IAW AR 40-501.  No other conditions were submitted by the MEB.  The PEB adjudicated the 
right knee condition as unfitting, rated 10%, referencing the US Army Physical Disability Agency 
(USAPDA) pain policy.  The CI made no appeals, and was medically separated with that disability 
rating. 
 
 
CI  CONTENTION:  The  application  states  simply:  “The  right  knee  has  also  caused  low  back 
issues.”    She  does  not  elaborate  further  or  specify  a  request  for  Board  consideration  of  any 
additional conditions. 
 
 
SCOPE  OF  REVIEW:    The  Board  wishes  to  clarify  that  the  scope  of  its  review  as  defined  in 
Department of Defense Instruction (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  rating for  the unfitting  right  knee  is  addressed 
below.  The low back condition specified in the application was not identified and adjudicated 
by  the  PEB;  e.g.,  it  does  not  satisfy  scope  requirements.    That  condition,  and  any  other 
conditions  or  contention  not  requested  in  this  application,  remain  eligible  for  future 
consideration by the Army Board for Correction of Military Records.  IAW DoDI 6040.44, the 
Board’s  authority 
recommendations  on  correcting  disability 
determinations.    The  Board’s  role  is  thus  confined  to  the  review  of  medical  records  and  all 
evidence  at hand  to  assess  the fairness  of  PEB rating determinations,  compared  to  Veterans 
Administration Schedule for Rating Disabilities (VASRD) standards, based on ratable severity at 
the time of separation.  
 
 
RATING COMPARISON:  
 

to  making 

is 

limited 

Service IPEB – Dated 20020628 
Code 

Condition 

RPS, Right Knee 

5099-5003 
No Additional MEB/PEB Entries 

Rating 
10% 

Combined:  10% 

VA (6 Mos. Post-Separation) – Effective 20020901 
Condition 

Code 

RPS, Right Knee 

5299-5260 
0% X 4 / Not Service Connected x 7 

 

Combined:  10% 

Rating 
10% 

Exam 

20030226 
20030226 

ANALYSIS SUMMARY:  
 
Right Knee Condition.  The CI suffered a strain type injury during basic training in October 2000 
which she ascribed to oversize boots.  She suffered persistent pain, which was initially managed 
conservatively  as  a  strain.    In  October  2001,  imaging  demonstrated  a  medial  meniscal  injury 
without  a  tear.    Surgery  was  not  recommended,  and  the  working  diagnosis  was  RPS.    Her 
symptoms did not respond adequately to physical therapy, local injections, or analgesics.  The 
narrative summary (NARSUM) recorded, “She states her right knee locks and also pops and she 
cannot use her right leg for more than three to four hours secondary to the knee swelling.”  The 
physical  exam  noted  medial  joint  line  tenderness  without  effusion,  and  normal  neurological 
findings.  It noted “full range of motion”, but “pain with flexion”.  Concurrent outpatient notes 
recorded normal gait, stability to stress testing, and no signs of meniscal impingement.  At the 
VA Compensation and Pension (C&P) exam, performed 6 months after separation, the examiner 
recorded  “constant  pain,  stiffness,  fatigability,  lack  of  endurance,  give  way,  lockup,  and 
weakness,  as  well  as  instability;”  with  use  of  a  brace  and  pain  flares  rated  10/10.    The  VA 
physical exam noted “a right leg limp,” crepitus, medial and lateral tenderness, and grimace to 
stress  maneuvers.    There  was  no  effusion,  laxity  to  stress  testing,  or  signs  of  meniscal 
impingement.  Range-of-motion (ROM) was “full with stated pain and wincing.”   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB’s 10% rating analogous to 5003 (degenerative arthritis) was supported by the USAPDA pain 
policy,  but  was  compliant  with  VASRD  §4.71a  criteria.    The  VA’s  10%  rating  under  5260 
(limitation of flexion) was conferred with citation of VASRD §4.59 (painful motion).  The Board 
members  considered  rating  under  code  5258  (cartilage,  semilunar,  dislocated,  with  frequent 
episodes of “locking,” pain, and effusion into the joint); but the absence of loose cartilage was 
confirmed by imaging, there was no mechanical locking by exam, and there is no evidence that 
the subjectively reported locking was frequent or ever associated with effusion.  There were no 
other  clinical  features  which  would  allow  a  rating  higher than  10%  under  any  alternate  joint 
code,  or  ligamental  laxity  which  would  permit  additional  rating  for  instability.    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 of 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.  As discussed above, PEB 
reliance on the USAPDA pain policy for rating the knee condition was operant in this case and it 
was  adjudicated  independently  of  that  policy  by  the  Board.    In  the  matter  of  the  right  knee 
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: 
 

Retropatellar Pain Syndrome, Right Knee 

UNFITTING CONDITION 

VASRD CODE  RATING 
5099-5003 
COMBINED 

10% 
10% 

 
 
 

   2                                                           PD12-00616 

 

The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 200208031, w/atchs. 
Exhibit B.  Service Treatment Record. 
Exhibit C.  Department of Veterans Affairs Treatment Record. 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

   3                                                           PD12-00616 

 

 
 

 
 
 

 
 
 

 
 
 

 
 
 

 
 

 
 
 

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 
XXXXXXXXXXXXXXXXXX, AR20120020539 (PD201200616) 
 
 
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 
 
 
 
CF:  
(  ) DoD PDBR 
(  ) DVA 
 
 

     XXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards) 

 
 
 

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