RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  ARMY 
SEPARATION DATE:  20090312 

 
NAME:  XXXXXXXXXXXXXXX 
CASE NUMBER:  PD1100697 
BOARD DATE:  20130124   
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was a troop unit active drilling National Guard CPT/O-3 (15A00/Chinook 
Pilot), medically separated for degenerative arthritis lumbar spine and left lower extremity S1 
radicular pain. The CI noted increasing back pain while activated and deployed to Afghanistan 
as  a  Chinook  pilot,  without  an  inciting  event.    After  redeployment,  he  underwent  extensive 
therapy,  treatment  and  microdiscectomy  surgery  in  July  2006.    His  degenerative  arthritis 
lumbar  spine  (back  pain)  condition  did  not  improve  adequately  to  meet  the  physical 
requirements  of  his  Military  Occupational  Specialty  (MOS)  or  to  satisfy  physical  fitness 
standards.  He was issued a permanent L3 profile and referred for a Medical Evaluation Board 
(MEB).    The  MEB  forwarded  no  other  conditions  for  Physical  Evaluation  Board  (PEB) 
adjudication.    The  PEB  adjudicated  the  degenerative  arthritis  lumbar  spine  and  left  lower 
extremity  S1  radicular  pain  conditions  as  unfitting,  rated  10%  and  10%  respectively,  with 
application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD).  The CI made no 
appeals, and was medically separated with a 20% disability rating.   
 
 
CI CONTENTION:  The CI attached a 2 page memorandum to his application which was prepared 
by his legal counsel asserting a variety of issues.  It was reviewed by the Board and considered 
in its recommendations. 
 
 
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 unfitting conditions of degenerative 
arthritis lumbar spine and left lower extremity S1 radicular pain meet the criteria prescribed in 
DoDI  6040.44  for  Board  purview,  and  are  accordingly  addressed  below.    The  requested 
conditions of PTSD (rated by the VA), radiculopathy right extremity and migraine headaches are 
not within the Board’s purview.  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 (ABCMR).   
 
 
RATING COMPARISON:   
 

Service IPEB – Dated 20081104 

VA (7 Mo. After Separation) – All Effective Date 20090304 

Condition 

Degenerative Arthritis 
Lumbar Spine 
Lt Lower Extremity S1 
Radicular Pain 

Code 
5242 

Rating 
10% 

8799-8720 

10% 

Condition 

S/P Partial Discectomy w/ 
Lumbar DDD 
Radiculopathy, Lt Lower 
Extremity 

Code 
5242 

Rating 
20% 

Exam 

20091013 

8599-8529 

0% 

20091013 

↓No Additional MEB/PEB Entries↓ 

PTSD 

30% 
0% x 3 (Includes Above)/Not Service Connected x 2 

9411 

20090731 
20090731 

Combined:  20% 

Combined:  40% 

ANALYSIS SUMMARY:  The Board acknowledges the CI’s contention in his legal counsel’s memo 
concerning alleged unfair medical care and assistance.  It is noted for the record that the Board 
has  neither  the  jurisdiction  nor  authority  to  scrutinize,  render  opinions,  or  offer  remedy  in 
reference to decisions of this nature.  That jurisdiction and authority resides with the ABCMR.  
IAW DoDI 6040.44, the Board’s authority is limited to making 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 
VASRD standards, based on severity at the time of separation.   
 
Degenerative  Arthritis  Lumbar  Spine  (Back  Pain)  Condition.    The  range-of-motion  (ROM) 
evaluations in evidence which the Board weighed in arriving at its rating recommendation, with 
documentation of additional ratable criteria, are summarized in the chart below. 

ROM - Thoracolumbar 

Flex (0-90) 
Ext (0-30) 

R Lat Flex (0-30) 
L Lat Flex 0-30) 
R Rotation (0-30) 
L Rotation (0-30) 
COMBINED (240) 

*Comment 

                        
MEB ~5 Mo. Pre-Sep  

90⁰ 
20⁰ 

(30⁰) 34⁰ 
(30⁰) 36⁰ 
(30⁰) 45⁰ 
(30⁰) 45⁰ 

230⁰ 

Goniometer used; + pain 
with lumbar motion; + 
lumbar spasm; normal 

gait 
10% 

VA C&P ~7 Mo. After-Sep  

50⁰ 
10⁰ 
25⁰ 
25⁰ 

(30⁰) 45⁰ 
(30⁰) 45⁰ 

170⁰ 

+ Pain with motion; “no 
Deluca criteria”; + tender; 

normal curvature 

20% 

§4.71a Rating 

* VASRD Spine Notes (2) and (4) applied  

 

 
 
At the MEB exam (5 months prior to separation), the CI reported chronic daily pain, especially 
with  prolonged  sitting  and  long  walks.    He  used  no  medications.    The  MEB  physical  exam 
documented lumbar spasm and discomfort with motion of the lumbar spine, without fatigue, 
decreased  endurance,  nor  incoordination.    Gait  and  station  was  normal.    The  CI  had  no 
weakness  and  no  abnormal  spine  contour.    A  2008  X-ray  revealed  mild  L4-5  disc  space 
narrowing and mild facet sclerosis.  A 2008 magnetic resonance imaging (MRI) revealed mild 
disc bulges at L4-5 and L5-S1.  The exam and ROMs are summarized in the chart above; sensory 
and motor findings are summarized in the discussion of the CI’s unfitting peripheral neuropathy 
condition below.  At the VA Compensation and Pension (C&P) exam, 7 months after separation, 
the  CI  reported  chronic  daily  pain,  numbness  and  weakness  with  radiation  to  both  lower 
extremities.  He described flares of being “unable to move…for 15 seconds” after sneezes.  The 
VA  physical  exam  documented  no  weakness  and  no  abnormal  spine  contour.    The  exam  is 
summarized above with motor and neurologic exams discussed below.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and the VA assigned the same VASRD code 5242 (degenerative arthritis of the spine), but at 
different  ratings  on  different  exam  findings.    The  PEB  based  its 10%  rating  on  the  finding  of 
muscle  spasm  not  resulting  in  abnormal  gait  or  abnormal  contour,  under  the  general  spine 

formula.  The VA based its rating on its examiner’s observed flexion of 50 degrees which met 
the  20%  rating  criteria.    There  is  a  disparity  between  these  ROM  examinations,  with 
implications for the Board's rating recommendation.  The Board thus carefully deliberated the 
probative value of these conflicting evaluations, and thoroughly reviewed the service treatment 
record for corroborating evidence from the period preceding separation.  The Board discussed 
the  fact  that  the  MEB  exam  was  prior  to,  and  closer  to,  the  date  of  separation.    The  Board 
noted that the sequence of exam findings suggested a worsening trend toward after the MEB 
examination,  without  evidence  of  further  trauma  or  injury.    The  Board  therefore  assigned 
higher  probative  value  to  the  MEB  exam  as  the  best  representation  of  the  pathology  and 
disability  that  resulted  in  the  termination  of  the  CI’s  military  career.   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 for 
the lumbar spine condition.   
 
Left Lower Extremity S1 Radicular Pain (Radiculopathy).  At the MEB exam, the CI reported that 
he experienced exertional radiating pain to his left lower extremity primarily in the calf and the 
top of the left foot.  The MEB physical exam documented straight leg raise caused pain near 45 
degrees on each side.  Sensory exam indicated no deficit for light touch and pinprick.  Deep 
tendon  reflexes  (DTR)  were  bilaterally  symmetric,  but  grossly  hyporeflexic  at  the  ankles 
(Achilles).  Motor examination was normal and symmetric with strength 5/5.  Multiple office 
visits and examinations proximate to the date of separation support the diagnosis of left lower 
extremity  radicular  symptoms.    Electrodiagnostic  testing  in  July  2008  demonstrated  left  S1 
radiculopathy  including  abnormal  muscle  activity  in  the  left  calf  (soleus).    Later  testing  in 
December 2008 (3 months prior to separation) after dictation of the MEB narrative summary 
(NARSUM)  documented  L4  radiculopathy  of  the  left  leg  with  moderate  axonal  tibial  motor 
neuropathy  and  plantar  neuropathy.    At  the  C&P  exam,  7  months  after  separation,  the  CI 
reported that he occasionally has pain in both legs, with numbness and weakness and that this 
caused his inability to weightlift and to fly a helicopter.  He did not use a brace, cane or crutch.  
The  VA  exam  documented  decreased  sensation  in  the  left  lateral  and  posterior  left  calf  and 
thigh, without atrophy or decreased motor strength.  Flexion and extension caused back pain 
without radiation.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  rated  the  CI’s  radiculopathy  condition  at  10%  coded  8799-8720,  analogously  to  sciatic 
nerve neuralgia (mild).  The VA rated the radiculopathy at 0% coded 8599-8529, analogously to 
external cutaneous nerve of thigh, paralysis (mild to moderate).  The pain-only component of 
the radiculopathy is considered under the CI’s unfitting low back condition IAW VASRD §4.71a 
since the general spine rating formula specifies that the rating is “with or without symptoms 
such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by 
residuals of injury or disease).”  The Board noted that the CI did not have motor impairment at 
either  examination,  but  agreed  that  the  sensory  component  of  his  left  lower  extremity  pain 
could have functional limitations in MOS duties as a helicopter pilot.  The evidence at the time 
of  separation  supported  coding  under  the  sciatic  nerve  code.    The  Board  considered  the 
provisions of VASRD §4.120 (evaluations by comparison), §4.123 (Neuritis, cranial or peripheral) 
and §4.124  (Neuralgia, cranial  or  peripheral).   There  were no organic changes  of the  left leg 
documented.  The Board determined that, in light of the CI’s lack of motor dysfunction, lack of 
medication use, and since his radiculopathy impairment consisted mainly of sensory and pain 
components  it  was  most  representative  of  mild  (10%)  impairment.    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 for 
the left lower extremity S1 radicular pain condition IAW VASRD §4.124a.   

______________________________________________________________________________   
 
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  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 degenerative arthritis lumbar spine condition, and IAW 
VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  In the 
matter  of  the  left  lower  extremity  S1  radicular  pain  condition  and  IAW  VASRD  §4.124a,  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 

VASRD CODE 

RATING 

5242 

8799-8720 
COMBINED 

10% 
10% 
20% 

Degenerative Arthritis Lumbar Spine 
Lt Lower Extremity S1 Radicular Pain 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20110822, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

           xxxxxxxxxxxxxxxxxxxx, DAF 
           Director 
           Physical Disability Board of Review 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / xxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxxxx, AR20130002259 (PD201100697) 
 
 
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 
 
 
 

     xxxxxxxxxxxxxxxxxxxxxx 
     Deputy Assistant Secretary 
         (Army Review Boards)