RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200876 SEPARATION DATE: 20030425 

BOARD DATE: 20130201 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (31R10/Multichannel System Operator 
Maintainer), medically separated for mechanical low back pain (LBP). The CI had LBP since a 
twisting injury in the summer of 2000, with a second injury in 2001. Despite physical therapy, 
trigger point injections and pain medications the CI did not improve adequately with treatment 
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 no other conditions for Informal Physical 
Evaluation Boar (IPEB) adjudication. The IPEB adjudicated the low back condition as unfitting, 
rated 0% with application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD) and 
likely AR 635-40. The CI appealed to the Formal PEB (FPEB) which increased the rating to 10%. 
The CI rebutted the FPEB determination and the US Army Physical Disability Agency (USAPDA) 
upheld the FPEB 10% adjudication. The CI was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: “I came in healthy and fit, after my service I have gain or held steady income, 
and due to my injuries has cause mental and physical problems.” (sic) 

 

 

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 mechanical LBP condition as 
requested for consideration meets the criteria prescribed in DoDI 6040.44 for Board purview 
and is addressed below. The other requested mental and physical conditions inferred in the 
application 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. 

 

 

RATING COMPARISON: 

 

Service FPEB – Dated 20021126 (5 mos pre-sep) 

VA (8 Mos. Pre-Sep) – All Effective Date 20030426 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Mechanical Low Back Pain 

5299-5295 

10% 

Mechanical Low Back Pain w/ 
DJD 

5293 

20%* 

20020719 

No Additional MEB/PEB Entries 

Residuals of Lightening Strike 

9999 

NSC 

20020719 

Combined: 10% 

Combined: 20% 



*VA rating increased to 40% effective 20050321; Chart based on VARD dated 20030429. VA added PTSD (9411) at 10% based 
on exam of 20031031 and effective 20030426 (Note: Subsequent rating changes not charted, but combined 70% and IU were 
effective in 2006). 

 

 

ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed in the CI’s application 
regarding the significant impact that his service-incurred condition has had on his current 


earning ability and quality of life. It is a fact, however, that the Disability Evaluation System 
(DES) has neither the role nor the authority to compensate members for anticipated future 
severity or potential complications of conditions resulting in medical separation. This role and 
authority is granted by Congress to the Department of Veterans Affairs (DVA). 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 2003 VASRD coding and rating standards for the spine, which were in effect at the time of 
the CI’s separation, were updated 23 September 2002 for code 5293 (incapacitating episodes), 
and then changed to the current §4.71a rating standards on 26 September 2003. The older 
VASRD standards for rating based on range-of-motion (ROM) impairment were subject to the 
rater’s opinion regarding degree of severity, whereas the current standards specify rating 
thresholds in degrees of ROM impairment. The VASRD normal ROM values were not in effect 
prior to 20030926, and are for the combined thoracolumbar spine segment, whereas the older 
spine criteria considered the thoracic and lumbar spine segments separately. For the reader’s 
convenience, the 2002 rating codes under discussion in this case are excerpted here. 

 

5292 Spine, limitation of motion of, lumbar: 

 Severe.......................................................................................40 

 Moderate..................................................................................20 

 Slight.........................................................................................10 

5294 Sacro-iliac injury and weakness: 

5293 Intervertebral disc syndrome: 

Evaluate intervertebral disc syndrome (preoperatively or postoperatively) either on the total duration of 
incapacitating episodes over the past 12 months or by combining under Sec. 4.25 separate evaluations of its 
chronic orthopedic and neurologic manifestations along with evaluations for all other disabilities, whichever 
method results in the higher evaluation. 

With incapacitating episodes having a total duration of at least ## weeks during the past 12 months … (del) 

With incapacitating episodes having a total duration of at least one week but less than two weeks during the 
past 12 months.......................................................10 

Note (1): For purposes of evaluations under 5293, an incapacitating episode is a period of acute signs and 
symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment 
by a physician. … 

5295 Lumbosacral strain: 

 Severe; with listing of whole spine to opposite side, positive Goldthwaite's sign, marked limitation of forward 
bending in standing position, loss of lateral motion with osteoarthritic changes, or narrowing or irregularity of 
joint space, or some of the above with abnormal mobility on forced motion............................................40 

With muscle spasm on extreme forward bending, loss of lateral spine motion, unilateral, in standing 
position......................................................................................20 

 With characteristic pain on motion..............................................10 

 With slight subjective symptoms only............................................0 

 

Low Back Condition. The CI had a several year history of repeated twisting injuries without 
direct trauma to his low back since 2000 which persisted with frequent pain exacerbations and 
muscle spasms with occasional symptoms extending into his legs. Despite vigorous non-
surgical conservative treatments to include X-ray guided local injections, his symptoms failed to 
permanently resolve. Radiological imaging of the lumbar spine revealed small, 2-level bulging 
discs without evidence of bone narrowing or nerve entrapment. 

 

The 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. 

 

 

 

 


Lumbar ROM 

(degrees) 

VA C&P ~9 Mos.Pre-Sep 

(20020719) 

MEB ~8 Mos. Pre-Sep 

(20020808) 

PT ~2 Mos. Pre-Sep 

(20030226) 

Flexion 

45 (of 95 normal) 

40 

“mid-thigh” 

Ext 

10 (of 35) 

10 

“neutral” 

R Lat Flex 

15 (of 40) 

15 

“90%” 

L Lat Flex 

20 (of 40) 

20 

“50%” 

R Rotation 

20 (of 35) 

15 

 

L Rotation 

20 (of 35) 

15 

Combined 

130 

115 

Comment 

normal gait; + spasms; + 
painful motion; included 
DeLuca 

Stiff gait; Waddell’s 4/5; 
normal contour 

“Gait with mild 
decreased stance 
right” 

§4.71a Rating 

20% 

20% (PEB 10%) 

20% 



The listed normal ROMs for the Pre-Sep VA exam are as stated by the examiner. 

 

At the MEB exam, 8 months prior to separation, the CI reported continued LBP which limited 
him to performing “minimal tasks” during the day. The MEB physical exam noted a stiff gait but 
“able to perform tandem gait maneuvers without difficulty.” The exam is summarized above 
with ROM “of the lumbar spine is the same” (referring to the charted ROMs above). There was 
a treatment note for a two day exacerbation of pain indicating inability to forward flex over 10 
degrees with 4/5 Waddell’s and the examiner reported “+ element of 2 degrees gain with duty 
today”. At the VA Compensation and Pension (C&P) exam, (performed 9 months prior to 
separation) the CI reported LBP and spasm at a minimum of three times a week. Although the 
charted PT examination, about 2 months prior to separation, which is most proximal to the CI’s 
date of separation, is void of goniometric or inclinometer measured degrees of motions, the 
examiner provided a valid description of the CI’s lumbar spine motion. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the back at 10% analogous to code 5295 (Lumbosacral strain; with characteristic pain 
on motion) citing the VASRD and AR 635-40. The VA rating of 20% was coded under 5293 
(Intervertebral disc syndrome). The rating determination noted the VA “assigned a 20 percent 
disability evaluation for the back condition based on recurring attacks of moderate 
intervertebral disc syndrome” which was under the spine criteria in effect at the time of the VA 
exam. That specific criterion was no longer in effect at the CI’s date of separation. The ROM 
evaluations of 45 degrees and 40 degrees of lumbar forward flexion in both VA and MEB 
examinations are consistent with a moderate limitation of lumbar motion (coded 5292 at 20%). 
Given the lack of specific normal value ROM or details on measurement techniques 
(goniometer or inclinometer) for the service ROM exam, the Board considered that normal 
flexion ROMs could range from 60 degrees to 95 degrees as gathered from the literature at the 
time. The VA examiner listed their interpretation of normal ROM values which appear similar 
to the measured ROMs at the MEB exam. The Board considered that that the PT exam most 
proximal to separation, indicated a comparable forward flexion of 30 degrees to 45 degrees 
that aligned with, or was slightly worse than, prior exams. There was no evidence of persistent 
symptoms characteristic of or compatible with a neuropathy. The examinations in evidence 
documented consistent limitation in lumbar forward flexion, lateral flexion, and rotation. The 
Board deliberated if the CI’s lumbar ROM limitations met the VASRD “severe” (40%), 
“moderate” (20%) or “slight” (10%) criteria. After due deliberation, considering all of the 
evidence and mindful of VASRD §4.3 (reasonable doubt), the Board majority recommends a 
disability rating of 20% for the low back condition and change of VASRD code to 5299-5292 to 
comply with the VASRD in effect at the time of separation. 

 

 

 


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 adjudication. As discussed above, PEB 
reliance on AR 635-40 for rating the low back condition was likely operant in this case and the 
condition was adjudicated independently of that instruction by the Board. In the matter of the 
mechanical LBP condition, by a vote of 2:1, the Board recommends a disability rating of 20% 
coded 5299-5292 IAW VASRD §4.71a. The single voter for dissent (who recommended no 
change from the PEB rating) did not elect to submit a minority opinion. 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: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Mechanical Low Back Pain 

5299-5292 

20% 

COMBINED 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120604, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

xxxxxxxxxxxxxxxxxxxxxxx, DAF 

Acting Director 

Physical Disability Board of Review 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxx, AR20130004605 (PD201200876) 

 

 

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 20% 
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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)