RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXX BRANCH OF SERVICE: ARMY
CASE NUMBER: PD1100572 SEPARATION DATE: 20090806
BOARD DATE: 20130122
SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this
covered individual (CI) was a Reserve SSG/E‐6 (68W/Health Medic) medically separated for low
back pain (LBP) due to lumbar intervertebral disc syndrome (IVDS). He was treated, but did not
improve adequately to fully perform his military duties or meet physical fitness standards. He
was issued a permanent profile and underwent a Medical Evaluation Board (MEB). The MEB
found his LBP condition medically unacceptable, and referred him to a Physical Evaluation
Board (PEB). No other conditions were listed on the DA Form 3947. The PEB found the LBP
condition unfitting, and rated it 20%, IAW the Veterans Administration Schedule for Rating
Disabilities (VASRD). The CI made no appeals, and was medically separated with 20% disability.
CI CONTENTION: “Lower Back is still causing me problems along with the pain that runs down
my left leg. I’m having numbness in the ball of my left foot that doesn’t go away. Mornings are
hard even to get out of bed and walking is getting more difficult. They are giving me stronger
medication but not fixing the problem.”
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 back pain condition (lumbar intervertebral disc syndrome)
meets the criteria prescribed in DoDI 6040.44, 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:
ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed by the CI regarding
the impairment with which his back condition continues to burden him, and the significant
impact that it has had on his quality of life. It is noted for the record that the Board is subject to
the same laws for disability entitlements as those under which the military Disability Evaluation
System (DES) operates. The DES has neither the role nor the authority to compensate the CI for
future severity or potential complications of conditions. That role and authority is granted to
the Department of Veterans Administration (DVA). The Board evaluates DVA evidence in
arriving at its recommendations, but its authority resides in evaluating the fairness of DES
fitness and rating determinations at the time of separation. Compensation can only be granted
Army PEB – dated 20090616
Condition
Lumbar IVDS
↓No Addi(cid:415)onal MEB/PEB Entries↓
Combined: 20%
Code
5243
Rating
20%
VA (4 mos. Post‐Separation) – All Effective 20090807
Condition
Lumbar Degenerative Changes
Radiculopathy, Left Leg
Left Shoulder Strain
Combined: 30%
Code
5242
8520
5299‐5203
Rating
10%
10%
10%
Exam
20091215
20091215
20091215
for the degree of severity present at separation. The DVA, however, is empowered to re‐
evaluate a CI’s conditions for the purpose of adjusting the disability rating should the degree of
impairment change over time.
Back Condition (Lumbar IVDS). The CI developed LBP in August 2007 while performing duties as
a military medic. The pain radiated down both legs, but was greater on the left. Magnetic
resonance imaging showed disc herniation at multiple levels. Numerous treatment options
were attempted, but his LBP persisted and an MEB was initiated. The CI had an orthopedic
evaluation in March 2009, 5 months prior to separation. At that exam, he reported pain 50% of
the time, which required daily narcotic use. Physical exam (PE) noted normal gait, and mild
tenderness to palpation (TTP) along the lumbosacral paraspinal muscles. Muscle strength was
normal for all major motor groups in both lower extremities. Sensation was also normal in both
lower extremities. Deep tendon reflexes were normal bilaterally. He had a weakly positive
supine straight leg raise, but it was negative in the seated position. Range‐of‐motion (ROM)
was measured by physical therapy, and is summarized in the chart below.
At his MEB evaluation on 11 May 2009, he had normal gait and a well‐aligned spinal column.
Heel‐toe tandem walks were performed with ease. Neurological exam was normal. ROM was
noted to be decreased, but was not actually measured. As noted above, the CI was medically
separated from the Army on 6 August 2009. Four months later, the CI had a VA Compensation
and Pension exam. He reported pain in the lower back, which radiated to the left leg and foot.
He also complained of numbness and tingling in the left foot. He had difficulty climbing stairs,
and inability to stand or walk for long periods. PE revealed normal gait, and normal spinal
contour. There was no pain with motion, and no TTP of the paraspinal muscles. Tone,
strength, sensation, and reflexes were all normal. Two ROM evaluations were weighed by the
Board in arriving at its rating recommendation, and are summarized below.
The Board carefully reviewed all evidentiary information available, and directs attention to its
rating recommendation based on the above evidence. The Army PEB and VA used different
coding and rating options for the CI’s LBP condition. The PEB coded his back condition as 5243
(intervertebral disc syndrome) and rated it 20%. The VA used code 5242 and rated him at 10%.
The Board unanimously agreed that the PEB had rated the LBP condition appropriately. The
Board could not find objective evidence in the record that would justify a disability rating
greater than 20%. All evidence was considered, and there is not reasonable doubt in the CI’s
favor supporting a change in the PEB’s adjudication of the lumbar spine condition.
The Board then considered the matter of radiculopathy. On examination, motor strength
testing had shown no objective evidence of muscle weakness. The CI’s radiculopathy was
subjective, and sensory only. After reviewing all of the information regarding the radicular
findings, there was insufficient evidence of a clinically significant neuropathy that interfered
with satisfactory performance of military duties. Therefore, his radiculopathy was not unfitting
at the time of separation from service. 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 back condition
(lumbar IVDS).
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
VA C&P – 19 weeks Post‐Sep
(20091215)
75⁰
225⁰
10%
MEB – 20½ weeks Pre‐Sep
(20090316)
55⁰
180⁰
20%
ROM – Thoracolumbar
Flexion (90⁰ is normal)
Combined (240⁰ is normal)
§4.71a Rating
2 PD11‐00572
inconsistent with the VASRD in effect at the time of the adjudication. The Board did not
surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD
were exercised. In the matter of the lumbar IVDS 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
Low Back Pain, due to Lumbar Intervertebral Disc Syndrome
VASRD CODE RATING
5243
COMBINED
20%
20%
The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20110802, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record
SFMR‐RB
XXXXXXXXXXXXXX, DAF
President
Physical Disability Board of Review
MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD‐ZB / XXXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA 22202‐3557
SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for
XXXXXXXXXXXXXXXX, AR20130001392 (PD201100572)
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:
3 PD11‐00572
Encl
XXXXXXXXXXXX
Deputy Assistant Secretary
(Army Review Boards)
CF:
( ) DoD PDBR
( ) DVA
4 PD11‐00572
AF | PDBR | CY2013 | PD 2013 00200
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AF | PDBR | CY2013 | PD-2013-01174
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AF | PDBR | CY2013 | PD-2013-02240
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