RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201259 SEPARATION DATE: 20020929 

BOARD DATE: 20130313 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty Soldier, SGT/E-5(77F/Petroleum Supply Specialist), 
medically separated for chronic back pain (LBP) due to lumbar degenerative disc disease (DDD). 
The CI injured his back while doing “gorilla” drills in February 2000. The CI did not improve 
adequately with conservative 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 lumbar DDD 
IAW AR 40-501. The MEB forwarded no other conditions for Informal Physical Evaluation Board 
(IPEB) adjudication. The IPEB adjudicated the lumbar spine condition as unfitting, rated 10%, 
with application of the Defense Instruction (DoDI) 1332.39, Paragraph 20, page 2-1-8 and the 
AR 635-40, Appendix B-39. The CI appealed to the Formal PEB (FPEB) [USAPDA], but withdrew 
his request, and was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: The CI states: “My rating for chronic lumbar pain due to degenerative disc 
disease should have been rated higher by the Army since the VA gave me 40% rating.” 

 

 

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. 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 20020628 

VA (3 Mos. Post-Separation) – All Effective Date 20020930 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Back Pain, Due to 
Lumbar DDD 

5299-5295 

10% 

Chronic Lumbar Pain Due to 
DDD 

5295 

40% 

20021230 

.No Additional MEB/PEB Entries. 

R Shoulder Impingement w/DJD 
of the Acromioclavicular 

5203 

10% 

20021230 

L Shoulder Impingement w/DJD 
of the Acromioclavicular 

5203 

10% 

20021230 

Neuritis R Upper Extremity to 
Include Hand 

5203-8615 

10% 

20021230 

Neuritis L Lower Extremity 

5295-8520 

10% 

20021230 

0% X 0 / Not Service-Connected x 4 

20021230 

Combined: 10% 

Combined: 60%* 



*Includes bilateral factor of 2.7%. 

 

 

ANALYSIS SUMMARY: The Board notes the current Department of Veterans Affairs (DVA) rating 
listed by the CI for his service-connected unfitting condition, but must emphasize that its 
recommendations are premised on severity at the time of separation. The DVA ratings which it 


considers in that regard are those rendered most proximate to separation. 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. That role and authority is granted by Congress to the DVA. 

 

Lumbar Spine Condition. The CI sought care for LBP after an auto accident in 1997 which was 
treated conservatively as a low back strain. He sought care once in 1999 for LBP and then in 
February 2000 sought care consistently for an increase in pain after gorilla drills and fireman's 
carry training. He noted some minimal radicular-type symptoms which traveled into his mid 
posterior hamstring region, the left side being greater than the right side. He attempted 
improvement of these symptoms through chiropractic care, physical therapy, massage, 
transcutaneous electrical nerve stimulation (TENS) unit, and medications, all of which had 
provided little to no improvement. He was referred to neurosurgery and subsequently had a 
discogram performed. The discogram produced no pain, but a large defect in L4-5 annulus was 
precluded as pressurizing the disc was interpreted as most likely the symptomatic level. 
Neurosurgery thus diagnosed likely discogenic LBP and educated him on his management 
options, in the meantime recommended a P3 permanent profile and referral for a MEB. There 
was one entry 2 months prior to separation for an acute flare in back pain that was treated 
conservatively in the emergency room and he was release with 72 hour bed rest. This was the 
only record in evidence for physician prescribed bed rest. The permanent profile limitations 
included no running, jumping, stooping or crawling, no physical training or testing, and no 
driving or riding in tactical vehicles. The profile allowed lifting up to 20 pounds, marching up to 
a mile, walking, bicycling, and swimming at own pace and distance, able to wear helmet, and 
carry and fire a rifle. The commander’s statement corroborated the medical condition and 
profile limitations with no additional remarks. 

 

At the MEB exam, the CI reported the LBP and associated radicular symptoms were increased 
with walking as well as with sitting for a prolonged period of time. The MEB physical exam 
demonstrated: full range-of-motion (ROM) with pain, tenderness in the bilateral sacroiliac areas 
to deep palpation, negative bilateral straight leg raise (SLR), (provocative test for disc disease), 
and normal bilateral lower extremity neuromuscular findings. At the VA Compensation and 
Pension (C&P) exam after separation, the CI reported constant, extreme pain and stiffness in 
the low back, with pain that radiated down the left leg which precluded him from taking out the 
trash, push a lawnmower, climbing stairs or gardening. He reported 8 to 10 weeks of lost time 
from work as his back required bed rest and treatment by a physician however he did not 
report the frequency for which he sought care. The C&P exam demonstrated: decreased 
painful flexion ROM of 75 degrees (90 normal), tenderness to palpation of the spinous 
processes of L1 through L4, radiating pain on movement down the left lower extremity, no 
muscle spasm, normal posture, negative bilateral SLR, decreased sensation down the left lower 
extremity and foot with no motor involvement, otherwise normal neuromuscular findings of 
the bilateral lower extremities and no Deluca observations. X-rays revealed decreased disc 
spaces at LI-L2, L4-L5, and L5-S1. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB and VA chose the same coding options for the condition, and based their rating 
recommendations IAW 2002 VASRD coding and rating standards for the spine, which were in 
effect at the time of separation, were modified on 23 September 2002 to add incapacitating 
episodes (5293, Intervertebral disc syndrome), and then were changed to the current §4.71a 
rating standards on 26 September 2003. The 2002 standards for rating based on 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. For the reader’s 
convenience, the 2002 rating codes under discussion in this case are excerpted below. 

 

 


5292 Spine, limitation of motion of, lumbar: 

Severe ………………………………………………………..……….………….... 40 

Moderate …………………………………….……………….…….…………...…. 20 

Slight ………………………………………………………..…………………...….10 

 

5293 Intervertebral disc syndrome: 

Pronounced; with persistent symptoms compatible with: sciatic 

 neuropathy with characteristic pain and demonstrable muscle 

 spasm, absent ankle jerk, or other neurological findings appropriate 

 to site of diseased disc, little intermittent relief ………………..….……….….. 60 

Severe; recurring attacks, with intermittent relief ……………..…….………..….…40 

Moderate; recurring attacks ……………………………….……………............…...20 

Mild ……………………………………………………………..…………….….…10 

Postoperative, cured …………………………………….………..……………....…..0 

 

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 osteo-arthritic 

 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 

 

The PEB’s DA Form 199 reflected application of the Defense Instruction (DoDI) 1332.39, 
Paragraph 20, page 2-1-8 and the AR 635-40, Appendix B-39 for rating, but its 10% 
determination was consistent with §4.71a standards. The VA assigned a 40% rating for 
lumbosacral strain with osteoarthritic changes, or narrowing or irregularity of joint space which 
is inconsistent with §4.71a standards as there is no evidence to this fairly specific rating criteria 
as noted above. The Board considered the 20% rating for 5295 which is also fairly specific as 
defined above. The CI’s condition clearly did not meet the criteria for a rating higher than 10% 
under the 5295 code based on either the MEB or the VA examinations. The Board also 
considered a rating under the 5292 code for limitation of spine motion and agreed the normal 
painful ROM documented by the MEB and mildly impaired VA exam would justify a “slight” 10% 
rating under this code. The Board next considered a rating under the 5293 code for 
intervertebral disc syndrome which fit with the CI’s underlying pathology. The 20% rating for 
‘moderate, recurring attacks’ could not be justified under 5293 based on lack of objective 
evidence of recurring incapacitating episodes which resulted in physician prescribed bed rest in 
the MEB exam, the post separation VA exam, nor the CI’s prior to separation treatment 
records. The Board finally considered whether additional rating could be recommended under 
a peripheral nerve code for the residual sciatic radiculopathy at separation. Firm Board 
precedent requires a functional impairment tied to fitness is required to support a 
recommendation for addition of a peripheral nerve rating to disability in spine cases. The pain 
component of a radiculopathy is subsumed under the general spine rating as specified in 
§4.71a. The sensory component in this case has no functional implications; and no motor 
weakness is in evidence. Since no evidence of functional impairment exists in this case, the 
Board cannot support a recommendation for additional rating based on peripheral nerve 
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 lumbar spine condition. 

 

 


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. As discussed above, PEB reliance on the Defense Instruction (DoDI) 1332.39, 
Paragraph 20, page 2-1-8 and the AR 635-40, Appendix B-39 for rating lumbar spine condition 
was operant in this case and the condition was adjudicated independently of that instruction by 
the Board. In the matter of the lumbar spine condition and IAW VASRD §4.71a, 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 

Chronic Back Pain, Due to Lumbar DDD 

5299-5295 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120716, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxx, AR20130006129 (PD201201259) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)