RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXX CASE: PD1201112 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130404 

SEPARATION DATE: 20030616 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was a Reserve MSG/E-8 (88Z50/Transportation Senior Sergeant) 
medically separated for chronic back pain. He had a long history of low back pain (LBP) from 
multiple motor vehicle accidents while on active duty. He was subsequently diagnosed with 
degenerative disc disease (DDD) and surgery was not indicated. The condition could not be 
adequately rehabilitated to meet the physical requirements of his Military Occupational 
Specialty (MOS) or satisfy physical fitness standards. He was issued a permanent U3/L3 profile 
and referred for a Medical Evaluation Board (MEB). The back condition, characterized as 
“degenerative disc disease, thoracic spine and low back pain” was forwarded to the Physical 
Evaluation Board (PEB) IAW AR 40-501. The MEB also identified and forwarded six other 
conditions as not disqualifying (see rating chart below) for PEB adjudication. The PEB 
adjudicated “chronic back pain with degenerative disc disease, thoracic spine” as unfitting, 
rated 10%. The remaining conditions were determined to be not disqualifying. The CI chose 
disability severance pay in lieu of retired pay at age 60, and was medically separated with a 10% 
disability rating. 

 

 

CI CONTENTION: “Veteran was rated as fail to meet retention criteria IAW AR40-501, D.D.D., 
Spine and Low Back, no rucking, no climbing, unable to grip, no lifting. The MEB. fail to address 
the issue that made me unfit. which was rated very low or not at all.” [sic] 

 

 

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. The bilateral carpal tunnel syndrome status post 
(s/p) surgery, right cubital tunnel syndrome s/p surgery, depression, hypertension, chronic low 
grade anemia, and hypercholesterolemia conditions requested for consideration and the 
unfitting back pain condition meet the criteria prescribed in DoDI 6040.44 for Board purview, 
and are accordingly 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 respective Army Board for Correction of Military Records. 

 

 


RATING COMPARISON: 

 

Service IPEB – Dated 20030313 

VA – (4 Mos. Post-Separation) 

and based on Service Treatment Records (STR) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Back Pain with 
Degenerative Disc Disease, 
Thoracic Spine 

5299-5295 

10% 

Lumbosacral Strain, Residuals of 
Low Back Injury 

5292 

10% 

20031027 

Thoracic Spine Condition 

5243 

NSC 

STR 

Bilateral Carpal Tunnel 
Syndrome, S/ P Surgery 

Not Disqualifying 

Bilateral Carpal Tunnel 
Syndrome 

8515 

NSC* 

20050321 

Right Cubital Tunnel 
Syndrome, S/P Surgery 

Not Disqualifying 

Right Cubital Tunnel Syndrome, 
Status Post (S/P) Surgery 

8599-8515 

NSC* 

20050321 

Depression 

Not Disqualifying 

Depression 

9435 

NSC 

STR 

Hypertension 

Not Disqualifying 

High Blood Pressure 

7101 

NSC 

STR 

Chronic Low-Grade Anemia 

Not Disqualifying 

Chronic Low-Grade Anemia 

7799-7716 

NSC 

STR 

Hypercholesterolemia 

Not Disqualifying 

No VA Entry 

No Additional MEB/PEB Entries 

Other x 8 

STR 

Combined: 10% 

Combined: 10% 



Derived from VA Rating Decision (VARD) dated 20040310 (most proximate to date of separation [DOS]). 

* Subsequent VARD 20060508 rated left and right 8515 at 10% each effective 20030506. 

 

 

ANALYSIS SUMMARY: 

 

Chronic Back Pain Condition. According to the MEB narrative summary (NARSUM), the CI had a 
23 year history of back pain which he attributed to several motor vehicle accidents, the last one 
being in 1998 when the CI was involved in a HUMVEE rollover accident during a period of 
military training. The CI was evaluated on several occasions by specialists and treated with 
profiling, medications and physical therapy. No surgical treatment was recommended at any 
time. The CI could not perform some of the activities required by his MOS as lifting more than 
20 pounds, running, jumping, or ruck marching and a MEB was initiated. The orthopedic MEB 
consult 7 January 2003, 5 months prior to separation, noted the CI complained of daily back 
pain aggravated by sudden movements. The CI was working at that time as a truck driver and 
was able to drive on local routes, taking breaks every 30 minutes. The CI was able to complete 
daily activities and denied any bowel or bladder incontinence, denied weakness in his legs. He 
stated he had occasionally lower extremity numbness that seemed to wax and wane. On 
physical examination, the spine was normal in appearance. The CI was able to bend and almost 
touch his toes. There was no significant pain with lateral bending and rotation. Neurologic and 
muscle strength functionality were intact and straight leg testing for radiculopathy was 
negative. The examiner noted prior X-rays of the spine from August 2002 that revealed some 
degenerative changes at T11-12 suggestive of an old injury, however vertebral disc height and 
alignment were normal. At the VA Compensation and Pension (C&P) exam performed on 
27 October 2003, 4 months after separation, the CI reported continuous pain with flare-ups 
when performing some specific movements like stooping, bending or lifting. The pain was 
localized to the low back and occasionally radiated to the buttocks area. No bladder or bowel 
dysfunction were noted. The CI was walking with a cane. The physical exam did not reveal any 
deformities of the spine. The dorso-lumbar range-of-motion (ROM) was: flexion of 80 degrees, 
extension of 10 degrees, and right lateral flexion of 10 degrees, left lateral flexion of 20 
degrees, rotation of 20 degrees bilaterally. No fatigue, weakness or lack of endurance were 
noted as well as no neurologic abnormalities, vertebral fractures or intervertebral disc 
syndrome. 

 

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 Veterans 
Affairs Schedule for Rating Disabilities (VASRD) in effect at the time of separation. The Board 
notes that the 2002 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 (effective 


26 September 2003, 3 months after separation). 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%, analogously to code 5295 (lumbosacral strain) citing 
pain with motion. The VA rated the back condition 10% (coded 5293-5292) citing slight 
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 and VA C&P examinations supported the 10% rating, 
slight, under the VASRD diagnostic code 5292. The Board next considered whether a higher 
rating was warranted under the guidelines for intervertebral syndrome, code 5293; however, 
there was no evidence of intervertebral disc syndrome or 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. The VASRD in effect at the time of separation had a separate 
code for dorsal spine (thoracic) limitation of motion. Board noted the degenerative changes at 
T11-12; however, STRs indicated LBP was the problem interfering with duty. Any additional 
rating under the dorsal spine code would be based on the same disability as that under the 
other codes discussed above and is prohibited by §4.14 (avoidance of pyramiding). 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 concluded that there was insufficient cause to recommend a 
change in the PEB adjudication for the chronic back pain with DDD, thoracic spine condition. 

 

Contended PEB Conditions. The contended conditions adjudicated as not unfitting by the PEB 
were bilateral carpal tunnel syndrome s/p surgery, right cubital tunnel syndrome s/p surgery, 
depression, hypertension, chronic low grade anemia, and hypercholesterolemia. The Board’s 
first charge with respect to these conditions is an assessment of the appropriateness of the 
PEB’s fitness adjudications. 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. According to the 
orthopedic MEB NARSUM, the CI had a history of bilateral carpal tunnel symptoms since 1982. 
He underwent carpal tunnel release surgery on the right in January 2002 and the left in July 
2002 with improvement in symptoms. There was no impairment in daily activities, however the 
CI complained of discomfort with performing pushups. The MEB examination noted intact two 
point discrimination and normal strength. Provocative examination maneuvers for nerve 
compression were negative. The CI reported a history of right cubital tunnel syndrome 
symptoms (compression of the ulnar nerve at the elbow) for many years leading to surgery in 
1993. He noted persistent numbness in the ulnar nerve distribution that was increased with 
examination maneuvers. Strength was intact. Both of these conditions had been present for 
many years without significantly interfering with duty. Depression was diagnosed in October 
2001 and treated with medication with relief of symptoms. At the time of the MEB 
examination elevated blood pressures were noted but did not indicate a disqualifying medical 
condition. A history of intermittent chronic low grade anemia was noted without underlying 
cause or related symptoms. Laboratory testing indicated hypercholesterolemia. None of these 
conditions were judged to fail retention standards by the MEB. All were reviewed and 
considered by the Board. There was no indication from the record that any of these conditions 
significantly interfered with satisfactory duty performance. 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 PEB fitness determination for the any of the 
contended conditions and, therefore, no additional disability ratings can be 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 back pain with DDD, thoracic spine condition and IAW VASRD §4.71a, the Board 
unanimously recommends no change in the PEB adjudication. In the matter of the contended 
bilateral carpal tunnel syndrome s/p surgery, right cubital tunnel syndrome s/p surgery, 
depression, hypertension, chronic low grade anemia, and hypercholesterolemia conditions, the 
Board unanimously recommends no change from the PEB determination as not unfitting. 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 

Chronic Back Pain with Degenerative Disc Disease, Thoracic Spine 

5299-5295 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120710, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx(PD201201112) 

 

 

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 xxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)