RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201549 SEPARATION DATE: 20030828 

BOARD DATE: 20130402 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an Active Duty PFC/E-3 (98G10/Linguist [in training]), medically 
separated for chronic low back pain (LBP) without radicular signs and chronic bilateral shin 
splints. The CI initially sought care for bilateral leg pains in October 2001 after walking. The CI’s 
LBP began in October 2002 and was felt to be related to the shin pain. The CI could not be 
adequately rehabilitated to meet the physical requirements of her Military Occupational 
Specialty (MOS) or satisfy physical fitness standards. She was issued a permanent L4 profile 
and referred for a Medical Evaluation Board (MEB). The MEB also identified and forwarded 
mild pes planus, identified in the rating chart below, as meeting retention standards. The PEB 
adjudicated the chronic LBP without radicular signs and chronic bilateral shin splints as 
unfitting, rated 10% and 0%, with application of the Veterans Affairs Schedule for Rating 
Disabilities (VASRD). The remaining condition was determined to be not unfitting and not 
ratable. The CI made no appeals and was medically separated. 

 

 

CI CONTENTION: “I was discharged based on a general/broad diagnosis of chronic pain. The 
cause of the pain was not determined until later by a VA doctor who diagnosed the pain as 
Fibromyalgia. This is what causes the pain and it was triggered by my service. I receive ongoing 
medical treatment because there is no known cure. Fibromyalgia causes daily pain in all areas 
of my body and affects my ability to lead a normal active life. I take medication on a daily basis 
to treat the pain. The diagnosis and rating I received at my time of discharge were not accurate 
or detailed and do not reflect the actual percent I am disabled and the affect it has on my life. 
Fibromyalgia affects everything I do on a daily basis and I am in constant pain.” 

 

 

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 chronic LBP and chronic bilateral shin splints conditions meet the criteria 
prescribed in DoDI 6040.44 for Board purview and are addressed below. The requested 
condition of fibromyalgia is 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 IPEB – Dated 20030715 

VA (1 Mos. Post-Separation) – All Effective Date 20030829 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic LBP w/o Radicular Signs 

5299-5295 

10% 

Chronic LBP 

5237 

10% 

20030930 

Chronic B/L Shin Splints 

5099-5022 

0% 

B/L Shin Splints 

5099-5022 

NSC* 

20030930 

Lt Tibia Stress Fracture 

5262 

NSC* 

20030930 

Mild Pes Planus 

Not Unfitting 

No Corresponding VA Entry 

.No Additional MEB/PEB Entries. 

0% X 0 / Not Service-Connected x 2 (includes above) 

20030930 

Combined: 10% 

Combined: 10% 



*Per VARD dated 20040105. 

 

 

ANALYSIS SUMMARY: The Disability Evaluation System (DES) is responsible for maintaining a fit 
and vital fighting force. While the DES considers all of the member's medical conditions, 
compensation can only be offered for those medical conditions that cut short a member’s 
career, and then only to the degree of severity present at the time of final disposition. 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 nor for conditions 
determined to be service-connected by the VA but not determined to be unfitting by the PEB. 
However the Department of Veteran Affairs (DVA), operating under a different set of laws (Title 
38, United States Code), is empowered to compensate all service-connected conditions and to 
periodically re-evaluate said conditions for the purpose of adjusting the Veteran’s disability 
rating should his degree of impairment vary over time. The Board’s role is confined to the 
review of medical records and all evidence at hand to assess the fairness of PEB rating 
determinations, compared to VASRD standards, based on severity at the time of separation. 

 

Chronic Low Back Pain without Radicular Signs Condition. The CI started complaining of 
significant LBP in October 2002. The pain was accompanied by tightness in the lumbar area and 
exacerbated by prolonged standing, sitting, twisting, and bending. Both the X-ray exam from 
15 January 2003 and magnetic resonance imaging (MRI) exam from 3 February 2003 were 
negative for any lumbosacral spine pathology. Treatment including physical therapy (PT) was 
not useful in alleviating the back pain. A permanent profile was assigned because the CI could 
not perform any Army physical fitness tests or strenuous physical activity, and a MEB was 
recommended. The MEB narrative summary (NARSUM) from 11 June 2003, 6 weeks prior to 
separation, noted the CI reported constant pain, rated higher on the left side, radiating upward 
the thoracic spine and periodically to the right leg. She stated the pain was alleviated for short 
periods of time by heat, ice, stretching and lying down. The physical exam noted full range-of-
motion (ROM) accompanied by pain and tenderness to palpation bilaterally in the sacroiliac 
joints and paraspinal muscles, accentuated on the right side. There was no evidence of 
abnormal contour. On 30 September 2003, at the VA Compensation and Pension (C&P) 
examination, a month after separation, the CI reported continued back pain, radiating to the 
right shoulder, hips, buttocks and hamstrings bilaterally. The CI rated the pain greater on the 
right side, sharp in nature and exacerbated by increased activity. On examination the CI was in 
no apparent distress and had a normal gait and posture. ROM of the lumbosacral spine was 
described as “perfectly normal” and not painful. Deep tendon reflexes (DTR) were 2+, 
symmetrical, with a normal motor and sensory exam, and negative straight leg raising (SLR) 
bilaterally. The examiner could not elicit any radiculopathy signs and diagnosed her condition 
as functional LBP. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the CI’s back pain condition at 10%, coded 5299-5295 (lumbosacral strain) using the 
2002 VASRD guidelines in effect at that time. The VA rating decision dated 16 October 2003 
assigned a 10% disability based on the current VASRD rating guidelines for diseases and injuries 
of the spine, (coded 5237) citing functional loss secondary to pain. These §4.71a rating criteria 


became effective in September 2003, a month after the CI separated. In accordance with DoDI 
6040.44, the Board is required to recommend a rating IAW the VASRD in effect at the time of 
separation, therefore the Board considered the rating recommendation based on application of 
codes 5292 (limitation of motion), 5293 (intervertebral disc syndrome), and 5295 (lumbosacral 
strain). No rating could be assigned considering codes 5292 and 5293 as there was no 
limitation of motion or intervertebral disc syndrome. No higher rating could be assigned under 
the lumbosacral strain code, 5295, as there was no muscle spasm or loss of lateral spine 
motion, unilateral, in a standing position. There was also no evidence of radiculopathy that 
would justify increasing the 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 LBP without radicular 
symptoms condition. 

 

Chronic Bilateral Shin Splints. The narrative summary (NARSUM) noted the CI started 
complaining of bilateral leg pain in October 2001. The pain was localized to the tibia region, 
exacerbated by walking and climbing stairs, and was not alleviated by PT and orthotics. While 
lower extremities X-ray exam from February 2002 was normal, bone scan from 7 March 2002 
noted mild periostitis of mid and distal tibias, greater on the right side, most compatible with 
shin splints. PT evaluation noted the CI had genu valgus and mild pes planus (both 
developmental characteristics) and it was considered that the strain of her tibias were 
secondary to a biomechanical factors. PT notes from 22 March 2002 to 8 January 2003 noted 
recurring shin pain with running and physical training. At the time of the MEB NARSUM 
examination 11 June 2003, there was tenderness to palpation bilaterally over the proximal 
medial tibias. ROM of the lower extremities was normal with normal gait with normal vascular, 
sensory and motor exam. At the VA C&P examination on 30 September 2003, a month after 
separation, there was normal motor and sensory function of the lower extremities with slight 
tenderness to palpation over the tibiae and no symptoms related to the previous suspicion of 
left tibia stress reaction/shin splints. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the condition 0% coding analogously to periostitis (5099-5022). The VA denied 
service-connection (and consequently rating) for the left tibia fracture and bilateral shin splints 
citing no evidence of a chronic disability related to service. Although the CI experienced shin 
splint pain with the vigorous physical activity associated with military training, the examinations 
proximate to separation including the MEB NARSUM and VA C&P examinations evidenced only 
mild tenderness with normal gait. 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 bilateral shin splints 
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. In the matter of the chronic LBP without radiculopathy condition and IAW 
VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication. In the 
matter of the chronic bilateral shin splints 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 Low Back Pain without Radiculopathy 

5299-5295 

10% 

Chronic Bilateral Shin Splints 

5099-5022 

0% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120816, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxx, AR20130009595 xxxxxxxxxxxxxxx 

 

 

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 xxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)