RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  ARMY  

 
NAME:  XXXXXXXXXX 
CASE NUMBER:  PD1200786                                                                 SEPARATION DATE:  20020603 
BOARD DATE:  20130103 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  SGT/E-5  (92Y/Unit  Supply  Specialist),  medically 
separated for chronic right knee pain.  The CI initially strained his right knee during a routine 
training run in 1999 and received conservative treatment.  After suffering from a second knee 
strain injury in 2001, an evaluation by orthopedics determined it was not a surgical condition.  
He  did  not  improve  adequately  with  continued  treatment  and  was  unable  to  meet  the 
requirements of his Military Occupational Specialty or satisfy physical fitness standards.  He was 
issued an L3 profile and referred for a Medical Evaluation Board (MEB).  The MEB forwarded 
right  knee  chronic  retropatellar  pain  syndrome  to  the  Physical  Evaluation  Board  (PEB)  as 
medically  unacceptable  IAW  AR  40-501.    Migraine  headaches  and  right  shoulder:    biceps 
tendinitis conditions, identified in the rating chart below, were also identified and forwarded by 
the MEB.  The PEB adjudicated the right knee chronic retropatellar pain syndrome condition as 
unfitting, rated 0% with likely application of the US Army Physical Disability Agency (USAPDA) 
pain policy.  The remaining conditions were determined to be not unfitting.  The CI made no 
appeals, and was medically separated with a 0% disability rating. 
 
 
CI CONTENTION:  “Constant pain in R knee and R shoulder.”  
 
 
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 conditions right knee chronic patellar 
pain  syndrome  and  right  shoulder  pain  as  requested  for  consideration  meet  the  criteria 
prescribed in DoDI 6040.44 for Board purview; and, are 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:   
 

Rating 
0% 

Knee 

Chronic 

Code 
5099-5003 

Service PEB – Dated 20020405 
Condition 
Right 
Patellar Pain Syndrome 
Right  Shoulder:  Biceps 
Tendinitis 
Migraine Headaches 
↓No Additional MEB/PEB Entries↓ 
Combined:  0% 
*Initial VA decision rated each at 0%, coded 5014-5260 and 5201 respectively; based on service treatment record.   
 
 

VA (12 Mos. Post-Separation)  – All Effective Date 20020604 
Condition 
Right  Knee  Retropatellar  Pain 
Syndrome 
Right  Shoulder 
Biceps Tendonitis 
Migraines 
0% x 1 / Not Service-Connected x 3 Additional 
Combined:  40% 

5299-5024 
Not Service Connected  

Not Unfitting 
Not Unfitting 

Code 
5099-5261 

Injury  with 

Rating 
30%* 

Exam 
20030613 

10%* 

20030613 

20030613 

ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding  the  significant  impairment  with  which  his  service-incurred  condition  continues  to 
burden  him.    The  Board  wishes  to  clarify  that  it  is  subject  to  the  same  laws  for  disability 
entitlements as those under which the Disability Evaluation System (DES) operates.  The DES 
has neither the role nor the authority to compensate members for anticipated future severity 
or  potential  complications  of  conditions  resulting  in  medical  separation.    That  role  and 
authority is granted by Congress to the Department of Veterans Affairs (DVA), operating under 
a different set of laws (Title 38, United States Code).  The Board utilizes DVA evidence proximal 
to  separation  in  arriving  at  its  recommendations;  and,  DoDI  6040.44  defines  a  12-month 
interval for special consideration to post-separation evidence.  The Board’s authority as defined 
in DoDI 6044.40, however, resides in evaluating the fairness of DES fitness determinations and 
rating decisions for disability at the time of separation.  Post-separation evidence therefore is 
probative only to the extent that it reasonably reflects the disability and fitness implications at 
the  time  of  separation.    The  Board  further  acknowledges  the  CI’s  contention  for  ratings  for 
other conditions documented at the time of separation, and notes that its recommendations in 
that  regard  must  comply  with  the  same  governance.    While  the  DES  considers  all  of  the 
member's medical conditions, compensation can only be offered for those medical conditions 
that cut  short a member’s career, and then only to the degree of severity present at the time 
of  final  disposition.    The  DVA,  however,  is  empowered  to  compensate  service-connected 
conditions  and  to  periodically  re-evaluate  said  conditions  for  the  purpose  of  adjusting  the 
Veteran’s disability rating should the degree of impairment vary over time. 
 
Right  Knee  Pain  Condition.    Magnetic  resonance  imaging  revealed  slight  irregularity  of  the 
medical meniscus, but no major tears or other abnormalities.  X-ray was normal.  There were 
three  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. 
 

NARSUM ~2.5 Mo. Pre-Sep 
140⁰ 
0⁰ 
+Tenderness 
10% 

VA C&P ~12 Mo. Post-Sep 
110⁰ 
-9⁰ 
+Painful motion 
10% (VA 30%)* 

Right Knee ROM 
Flexion (140⁰ Normal) 
Extension (0⁰ Normal) 
Comment 
§4.71a Rating 

MEB ~4 Mo. Pre-Sep 
140⁰ 
0⁰ 
+Tenderness 
10% 

    *Rating decision incorporated additional loss of motion against resistance 
 
An orthopedic addendum narrative summary (NARSUM) prepared 3 months prior to separation 
indicated that there was no surgical indication for the knee condition.  Examination revealed 
“full active range of motion,” no crepitus and stable ligaments.  At the NARSUM exam 2 months 
prior to separation, the CI reported recurrent pain and swelling of the right knee with overuse.  
Pain  was  caused  by  walking  more  than  a  mile,  climbing  stairs,  riding  a  bike,  squatting,  and 
kneeling.    Over  the  counter  medication  was  used  for  pain.    Examination  revealed  no  laxity, 
effusion,  warmth  or  redness.    At  the  VA  Compensation  and  Pension  exam  over  a  year  after 
separation, the CI reported that symptoms had increased.  Pain occurred after walking a half 
mile  and  he  could  no  longer  run.    Examination  revealed  additional  loss  of  extension  of  -11 
degrees with resistance.  Ligament testing caused pain but stability was not specified.  X-rays 
were negative. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and VA chose different coding options for the condition, but this did not bear on rating.  
The  PEB  assigned  a  0%  rating  under  an  analogous  5003  code  (degenerative  arthritis)  with 
application of the USAPDA pain policy.  The VA exam was over a year after separation, and the 
Board therefore relied more heavily on the exams as an accurate indicator of disability severity 
at  the  time  of  separation.    Although  there  was  no  limitation  of  motion,  there  is  sufficient 
evidence of pain with use (§4.40, Functional loss) to justify a minimal compensable rating under 

   2                                                           PD1200786 
 

§4.71a.    The  Board  could  find  no  support  for  rating  higher  than  10%  under  alternate  knee 
codes.    After  due  deliberation,  considering  all  of  the  evidence  and  mindful  of  VASRD  §4.3 
(Resolution of reasonable doubt), the Board recommends a disability rating of 10% for the right 
knee pain condition.   
 
Contended PEB Conditions.  The contended condition adjudicated as not unfitting by the PEB 
was right shoulder pain.  The Board’s first charge with respect to this condition is an assessment 
of the appropriateness of the PEB’s fitness adjudication.  The Board’s threshold for countering 
fitness determinations is higher than the VASRD §4.3 (Resolution of reasonable doubt) standard 
used  for  its  rating  recommendations,  but  remains  adherent  to  the  DoDI  6040.44  “fair  and 
equitable” standard.  This condition was not profiled, was not implicated in the commander’s 
statement and was not judged to fail retention standards.  It was reviewed by the action officer 
and considered by the Board.  There was no indication from the record that the right shoulder 
condition significantly interfered with satisfactory duty performance.  After due deliberation in 
consideration  of  the  preponderance  of  the  evidence,  the  Board  concluded  that  there  was 
insufficient  cause  to  recommend  a  change  in  the  PEB  fitness  determination  for  the  right 
shoulder  biceps  tendinitis  condition;  and,  therefore,  no  additional  disability  ratings  can  be 
recommended. 
 
 
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 right knee pain was operant in this case and the 
condition was adjudicated independently of that policy by the Board.  In the matter of the right 
knee  chronic  retropatellar  pain  syndrome  condition,  the  Board  unanimously  recommends  a 
disability rating of 10%, coded 5099-5003 IAW VASRD §4.71a.  In the matter of the contended 
right shoulder biceps tendinitis condition, the Board unanimously recommends no change from 
the  PEB  determination  as  not  unfitting.    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  RATING 
5099-5003 
COMBINED 

10% 
10% 

UNFITTING CONDITION 
Right Knee Chronic Retropatellar Pain Syndrome 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120613, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 

           xxxxxxxxxxxxxxxx, DAF 
           Director 
           Physical Disability Board of Review 

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SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / xxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for xxxxxxxxxxxxxxxxx, AR20130002250 (PD201200786) 
 
 
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 
 
 
 
 

     xxxxxxxxxxxxxxxxxxxxx 
     Deputy Assistant Secretary 
         (Army Review Boards) 

 
 
 

 
 
 

 
 
 

 
 
 

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