RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200938 SEPARATION DATE: 20030430 

BOARD DATE: 20130129 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (54B/Chemical Operations Specialist), 
medically separated for chronic low back pain (LBP) due to multi-level degenerative disc disease 
(DDD) of the lumbosacral spine. He did not improve adequately with treatment and was unable 
to meet the physical requirements of his Military Occupational Specialty or satisfy physical 
fitness standards. He was issued a L3 Profile and referred for a Medical Evaluation Board 
(MEB). Plantar fasciitis, retropatellar pain syndrome (RPPS), obesity and meralgia paresthetica 
conditions, identified in the rating chart below, were also identified and forwarded by the MEB. 
The Physical Evaluation Board (PEB) adjudicated the chronic LBP condition as unfitting, rated 
10% with likely application of US Army Physical Disability Agency (USAPDA) pain policy. The 
remaining conditions were determined to be not unfitting or not ratable (in the case of 
obesity). The CI made no appeals, and was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: “My medical condition has gotten worse and am becoming limited to daily 
activities”. 

 

 

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 rated condition chronic LBP due to 
multi-level DDD of the lumbosacral spine is the only condition that meets the criteria prescribed 
in DoDI 6040.44 for Board purview; and, is 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: 

 

Service PEB – Dated 20030114 

VA (1 Mo. Pre-Separation) – All Effective Date 20030501 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Low Back Pain 

5295 

10% 

Lumbar Spine Degen. Disc Dis. 

5293-5292 

40% 

20030401 

Retropatellar Pain Syndrome 

Not Unfitting 

Lt Knee Retropatellar Pain 

5099-5014 

10% 

20030401 

Rt Knee Retropatellar Pain 

5099-5014 

10% 

20030401 

Plantar Fasciitis 

Not Unfitting 

Bilateral Plantar Fasciitis 

5299-5276 

10% 

20030401 

Meralgia Paresthetica 

Not Unfitting 

NO VA ENTRY 

Obesity 

Not a Ratable 
Condition 

NO VA ENTRY 

.No Additional MEB/PEB Entries. 

0% X 1 

 

Combined: 10% 

Combined: 60% 



 

 

 

 

 


ANALYSIS SUMMARY: 

 

Chronic Low Back Pain Due to Multi-level Degenerative Disc Disease of the Lumbosacral Spine 
Condition. The MEB narrative summary (NARSUM), dictated 28 August 2002, noted chronic 
intermittent LBP since a motorcycle accident in 1998 and aggravated by a subsequent motor 
vehicle accident in January 2001. He returned to duty but continued to complain of back pain 
aggravated by standing, walking, repeated bending, running and heavy lifting. Computed axial 
tomography (CAT) scan in December 2002 demonstrated multilevel degenerative lumbar disc 
disease with disc protrusion at several levels but no herniation. Conservative treatment was 
not helpful however surgery treatment was not considered necessary. An assessment on 
27 March 2002 noted chronic pain with a normal examination including flexion and gait. A 
physical therapy evaluation on 19 August 2002 noted painful motion with moderately limited 
motion (flexion 40 degrees, extension 10 degrees, lateral flexion 20 degrees both sides, and 
rotation 20 degrees both sides). Gait, posture, muscle strength and reflexes were normal. An 
orthopedic examination performed on 28 August 2002 also noted normal gait, passive flexion 
of 90 degrees and extension of 20 degrees. The MEB physical examination on 30 October 2002 
(DD Form 2808) recorded diffuse tenderness to pressure on the thoracolumbar spine region, no 
muscle spasms or deformity. Range -of-motion (ROM) was moderately limited by pain (flexion 
45 degrees, extension 20 degrees, lateral flexion 25 degrees both sides). Leg raising increased 
back pain without radicular symptoms. Reflexes were intact. Neurological examination was 
normal except for decreased sensation in the outer right thigh consistent with a possible L4 
nerve root dysfunction versus meralgia paresthetica (lateral femoral cutaneous nerve 
compression at the waist unrelated to back condition). The MEB NARSUM dated 20 December 
2002 cited the October 2002 MEB examination. At the VA Compensation and Pension (C&P) 
examination, performed on 1 April 2003, a month prior to separation, the exam of the lumbar 
spine revealed no asymmetry, deformity or focal tenderness or muscle spasms. Gait was 
normal. ROM was limited to 30 degrees flexion, 20 degrees extension, 15 degrees lateral 
flexion bilaterally. Pain was reported with all directions of motion. Lower extremity muscle 
strength and reflexes were normal. 

 

The Board directs attention to its rating recommendation based on the above evidence. In 
accordance with DoDI 6040.44, the Board is required to recommend a rating IAW the VASRD in 
effect at the time of separation. The Board notes that the 2002 Veteran Administration 
Schedule for Rating Disabilities (VASRD) standards for the spine, which were in effect at the 
time of separation, were changed to the current §4.71a rating standards in 2004. The Board 
must correlate the above clinical data with the 2003 rating schedule (applicable diagnostic 
codes include: 5292 limitation of lumbar spine motion; 5293 intervertebral disc syndrome; 5295 
lumbosacral strain). The PEB rated the CI’s back pain condition at 10%, coded 5295 
(lumbosacral strain) citing pain with motion without spasm (but also noted moderate limitation 
of motion). The VA rated the back condition 40% (coded 5293-5292) citing severe limitation of 
motion at the time of the C&P examination. The Board considered the rating under the VASRD 
diagnostic code 5292, limitation of lumbar motion. The Board agreed that the ROM 
documented at the time of the MEB examination supported the 20% rating, moderate, under 
the VASRD diagnostic code 5292. The Board noted the worsened ROM at the time of the C&P 
examination; however it was not consistent with previous examinations or the absence of 
spasm, and was otherwise unexplained by any cause for worsening. The CI had a chronic 
condition, and the preponderance of evidence more nearly approximated the moderate 
limitation than the severe. The Board next considered whether a higher rating was warranted 
under the guidelines for intervertebral syndrome, code 5293, however there were no 
incapacitating episodes to support a minimum rating under this code. The Board also 
considered the rating under the code, 5295, lumbosacral strain but concluded the 
preponderance of evidence did not support a rating higher that the 10% rating assigned by the 
PEB. There was characteristic pain on motion but no muscle spasm, or unilateral loss of lateral 
motion, or evidence of severe strain with listing or marked limitation of motion. There was no 


evidence of ratable peripheral nerve impairment which would provide for additional or higher 
rating. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 
(reasonable doubt), the Board recommends a disability rating of 20% for the chronic LBP 
condition coded 5292. 

 

 

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. In the matter of the 
chronic LBP condition, the Board unanimously recommends a disability rating of 20% coded 
5292 IAW VASRD §4.71a. 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 

Chronic Low Back Pain 

5293-5292 

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 

 

 

 

 

 

 XXXXXXXXXXXXXXXXXX, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

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, AR20130003831 (PD201200938) 

 

 

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 XXXXXXXXXXXXXXX 

 Deputy Assistant Secretary 

 (Army Review Boards)