RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200947 SEPARATION DATE: 20040105 

BOARD DATE: 20130307 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (52C10/Air Condition Technician), medically 
separated for “chronic low back pain due to lumbar disc disease, without neurologic 
abnormality.” Early in 2002 he experienced sudden low back pain (LBP) while dragging a heavy 
cable. He had a magnetic resonance imaging (MRI) exam of the lumbar spine which showed a 
small annular tear and disc bulge at LS1. He was seen by orthopedics and the assessment was 
that he does not need surgery and that the MRI findings were not sufficient to warrant this 
procedure. Conservative management was recommended and permanent profile indicated no 
stooping, bending, or crawling, limit runs and situps. The CI had no duty restrictions placed on 
him due to his medical condition, and was limited to alternate Army Physical Fitness Test 
(APFT). 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 chronic LBP due to lumbar disc disease, without neurologic 
abnormality as unfitting, rated 10%. The CI made no appeals, and was medically separated with 
a 10% disability rating. 

 

 

CI CONTENTION: “After my lower back surgery conditions of my leg got worse, numbness of leg 
sometimes makes it hard to drive. And I feel as though I can’t always do things my job often 
requires of me. I do well to go to work every day.” 

 

 

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, 
paragraph 5.e.(2). It is limited to those conditions determined by the PEB to be unfitting for 
continued military service and those conditions identified but not determined to be unfitting by 
the PEB when specifically requested by the CI. Ratings for unfitting conditions will be reviewed 
in all cases. The contended leg numbness is considered a contention for an unfitting and rated 
peripheral neurologic abnormality and will be addressed below, as part of the CI’s unfitting 
chronic low back pain condition. 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 IPEB – Dated 20031006 

VA - VARD 20060113 (most proximate to Date of Separation -3 yrs 
post) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Low Back Pain 
due to Lumbar Disc 
Disease, without 
Neurologic Abnormality 

5243-
5299- 

5237 

10% 

Lower Back, Disc Condition 

5243 

0%* 

STR 

Combined: 10% 

Combined: 0% 



* VARD 20070829 increased 5243 to 20% based on 20070620 exam, effective 20070604 

 

 

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 service 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 evaluates DVA evidence 
proximal to separation in arriving at its recommendations, but its authority resides in evaluating 
the fairness of DES fitness decisions and rating determinations for disability 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. 

 

Chronic Low Back Pain Condition. The narrative summary (NARSUM) notes that the CI had back 
pain that was unresponsive to conservative measures. Surgery was not recommended. At the 
MEB exam, the CI reported back pain that radiated to both thighs. His pain was aggravated by 
heavy lifting and bending. He was taking pain medication 2-3 times per week and occasional 
Ibuprofen. The MEB physical exam noted some tenderness in the right lumbar paravertebral 
region. He was able to heel and toe walk without difficulty; sensation and reflexes were 
normal. ROM was measured with an inclinometer (listed VASRD goniometer normal ROM) and 
showed mildly reduced flexion of 80° (normal 90°); extension of 20° (normal 30°); and right 
lateral flexion of 15° (normal 30°); left lateral flexion and bilateral rotation were within normal. 
A VA Compensation and Pension (C&P) exam was not performed proximate to separation 
because the CI failed to report. The first C&P exam took place more than 3 years after 
separation, and documented forward flexion of 40° (combined 180° of normal 240°). VA 
records also documented later exams with worsening (VA 40% rating) and surgery in 2008. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated chronic LBP due to lumbar disc disease as 5243-5299-5237 (intervertebral disc 
syndrome analogous to lumbar strain) at 10%. The proximate VA rating based on the service 
treatment records (STR) was 5243 at 0%. Remote post-separation worsening and surgery was 
considered of little probative value for rating at the time of separation. There is no evidence in 
the record of incapacitating episodes as defined in the VASRD Formula for Rating Intervertebral 
Disc Syndrome Based on Incapacitating Episodes. In the absence of incapacitating episodes, the 
same rating criteria apply to either coding choice of 5243 (intervertebral disc syndrome) or 
5237 (lumbosacral strain) as specified in the VASRD General Rating Formula for Diseases and 
Injuries of the Spine. The spine rating formula 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 found that the CI’s chronic LBP condition most nearly met the 10% 


general rating criteria for forward flexion of the thoracolumbar spine greater than 60 degrees 
but not greater than 85 degrees; or localized tenderness not resulting in abnormal gait. The 
Board recommends coding as 5243 IAW VASRD guidelines in effect at the time of separation. 
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’s 10% adjudication for the chronic LBP condition, but that there should be a modification of 
coding to 5243 to comply with the VASRD in effect at the time of separation. 

 

Contended PEB Conditions. The CI’s contended: “After my lower back surgery conditions of my 
leg got worse, numbness of leg sometimes makes it hard to drive” was considered a contention 
for additional rating for a peripheral nerve rating (pain and numbness). The Board’s main 
charge is to assess the fairness of the PEB’s determination that there was no “neurologic 
abnormality” which was considered a PEB determination that there was no unfitting peripheral 
nerve condition. The chronic bilateral leg pain was appropriately combined under the unfitting 
back condition above, and is IAW the general spine formula that stipulates the spine 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’s threshold for 
countering fitness determinations is higher than the VASRD §4.3 (reasonable doubt) standard 
used for its rating recommendations, but remains adherent to the DoDI 6040.44 “fair and 
equitable” standard. The Board deliberated whether there was evidence of a separately 
ratable non-pain radiculopathy of either lower extremity. Board precedent is that a functional 
impairment tied to fitness is required to support a recommendation for addition of a peripheral 
nerve rating at separation. There were no fixed motor or sensory deficits, or reflex 
abnormalities. The spine surgery in 2008 and subsequent symptoms were considered post-
separation worsening. Based on the evidence in the record, there was insufficient evidence of 
functional impairment of either lower extremity proximate to separation. 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 implied PEB fitness determination 
for any non-pain radiculopathy or peripheral nerve condition and so no additional disability 
ratings are 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. In the matter of the 
chronic low back pain condition and IAW VASRD §4.71a, the Board unanimously recommends 
no change in the PEB’s 10% adjudication, but modification of the code to 5243. In the matter of 
the non-pain lower extremity (peripheral nerve) conditions, the Board unanimously 
recommends no change from the PEB’s implied determinations 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: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Chronic Low Back Pain due to Lumbar Disc Disease 

5243 

10% 

COMBINED 

10% 



 

 


The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120619, 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 / xxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxx, AR20130006037 (PD201200947) 

 

 

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 description 
without modification of the combined rating or 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)