RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  ARMY   
SEPARATION DATE:  20040701 

 
NAME:  XXXXXXXXXXXXXXXXXX 
CASE NUMBER:  PD1200768 
BOARD DATE:  20130103 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  activated  National  Guard  SSG/E-6  (95B30/Military  Policeman), 
medically  separated  for  chronic  left  knee  pain.    The  CI  complained  of  left  knee  pain  of  an 
insidious onset without history of trauma, since about 1998.  The CI could not be adequately 
rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS) or 
satisfy  physical  fitness  standards.    He  was  issued  a  permanent  L3  profile  and  referred  for  a 
Medical Evaluation Board (MEB).  The MEB forwarded left knee retropatellar pain syndrome, 
left knee Baker's cyst, and left knee joint effusion conditions for Physical Evaluation Board (PEB) 
adjudication.    After  reconsideration  of  initial  PEB  determinations,  the  PEB  adjudicated  the 
chronic left knee pain as unfitting, rated 0% with possible application of the US Army Physical 
Disability Agency (USAPDA) pain policy.  The CI did not appeal this last PEB decision, and was 
medically separated. 
 
 
CI CONTENTION:  “I was released from active duty while MEB pending.  Thus this should reflect 
a time in service which should qualify myself for retirement benefits.”   
 
 
SCOPE  OF  REVIEW:    The  Board’s  scope  of  review  is  defined  in  DoDI  6040.44,  Enclosure  3, 
paragraph 5.e.(2). It is limited to those conditions determined by the PEB to be unfitting for 
continued military service and those conditions identified but not determined to be unfitting by 
the PEB when specifically requested by the CI.  The rating for the unfitting condition, chronic 
left knee pain, 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:   
 

*VARD dated 20040204 granted rating effective 20010220 but noting the CI was not entitled to compensation for the 1 year he 
was on EAD after the grant of benefits.  As a result of a Notice of Disagreement, a DRO De Novo Review granted a retroactive 
effective date to 19991013 per VARD dated 20040915 but did not note that the CI was not entitled to VA compensation while 
on periods of active duty even though they acknowledge he was on active duty for one year from March 2002 to March 2003. 
 
 

 

Service Informal Reconsideration – Dated 20040518 
Rating 

Condition 

Code 

Chronic Lt Knee Pain 

5099-5003 

0% 

Lt Knee RPS 

Condition 

↓No Additional MEB/PEB Entries↓ 

Combined:  0% 

VA – All Effective Date 19991013* 

Code 

5257-5003 

Rating 
10% 

Not Service-Connected x 1 

Combined:  10% 

Exam 
STR 
STR 

ANALYSIS SUMMARY:   
 
Chronic Left Knee Pain Condition.  Service treatment records (STR) reflect a history of left knee 
pain  since  1998  without  specific  traumatic  trigger.    The  MEB  narrative  summary  (NARSUM) 
noted that over the years, the CI received treatment including medications and physical therapy 
(PT)  and  that  office  exams  revealed  joint  line  tenderness,  but  usually  full  range-of-motion 
(ROM)  without  swelling.    In  October  2002,  recurrent  left  knee  pain  developed  following  a 
physical  fitness  test  and  soft  ball  game  which  interfered  with  full  performance  of  duties.    A 
magnetic resonance imaging (MRI) scan showed a possible left knee degenerative meniscal tear 
and significant Baker's cyst and cartilage in the trochlea and patellar region consistent with a 
clinical diagnosis of retropatellar pain syndrome.  The MEB NARSUM examination recorded “full 
active range of motion” of the left knee, without instability.  The CI did have a dull ache in the 
back  of  the  knee  with  fullness  noted  consistent  with  the  Baker’s  cyst,  and  minimal 
patellofemoral  joint  crepitance  with  resisted  extension.    There  was  no  joint  line  tenderness 
suggestive of meniscus injury.  No VA Compensation and Pension (C&P) exam was performed 
within 12 months of the time of the CI’s last separation from the Army.  The VA referred to the 
MEB documents in making their decision.  A subsequent VA examination in March 2006, 2 years 
after separation recorded a similar examination with full ROM, no instability, negative meniscus 
signs, normal gait and normal X-rays. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB gave a rating of 0% for chronic left knee pain; in their decision, they noted that the CI was 
not using any pain medication.  The VA gave a rating of 10% due to painful or limited motion of 
a major joint.  There was no limitation of motion or instability to warrant a minimum rating 
under the respective VASRD diagnostic codes (5260, 5261, 5257).  The Board noted the MRI 
results showing a possible meniscus tear but the MRI did not show a dislocated meniscus and 
examinations were negative for meniscus signs and there was no locking to support a minimum 
rating under code 5258.  The Board considered whether a minimum rating was supported with 
application of code 5003, §4.59 (painful motion) or §4.40 (functional impairment).  The Board 
also noted that the record does reflect pain with use of the left knee for which the CI received 
medications, PT, and duty restrictions which supports application of VASRD §4.59 or §4.40 for a 
rating of 10%.  After due deliberation of the rating options, considering all of the evidence and 
mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for 
the left knee pain condition coded 5099-5003. 
 
 
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.  The Board surmised in 
this case that the PEB may have rated the chronic left knee pain 0% with likely application of 
the USAPDA pain policy and the condition was adjudicated independently of that policy by the 
Board.  In the matter of the chronic left knee pain condition and IAW VASRD §4.71a, the Board 
unanimously recommends a rating of 10%.  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 

COMBINED 

RATING 

10% 
10% 

Chronic Left Knee Pain 

UNFITTING CONDITION 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120612, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXXX, DAF 
           Director 
           Physical Disability Board of Review 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / XXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for XXXXXXXXXXXXXXXXXX, AR20130002286 (PD201200768) 
 
 
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 10% 
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 
 
 
 

     XXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)