RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXX CASE: PD1201587 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130411 

SEPARATION DATE: 20020903 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4(74B/COMPUTER SPECIALIST) medically 
separated for a lumbar spine condition due to lumbar degenerative disc disease (DDD). The CI’s 
back pain began during basic training in 1994 when she was told she had scoliosis. She was 
treated conservatively and symptoms did not exacerbate until the birth of her third child. 
Despite surgery, the lumbar spine condition 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 L3 profile and referred for a Medical Evaluation Board 
(MEB). The lumbar spine condition, characterized as chronic low back pain (LBP) secondary to 
DDD of the lumbar spine, and status post (s/p) left L5-S1 laminectomy and discectomy for 
lumbar herniated nucleus pulposus (HNP), was forwarded to the Physical Evaluation Board 
(PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The Informal PEB (IPEB) 
combined the two MEB conditions and adjudicated chronic LBP due to lumbar DDD, s/p L5-S1 
laminectomy and discectomy as unfitting, rated 10% with application of the Veteran’s Affairs 
Schedule for Rating Disabilities (VASRD). The CI made no appeals, and was medically separated 
with a 10% disability rating. 

 

 

CI CONTENTION: The CI writes: “A low back surgery was performed by military leaving soldier 
permantly disabled—Drs told soldier to return to Full duty after surgery which reinjured soldier 
to the point of medical discharged. Soldier was push away from Drs early on when treatment & 
prevention could have been performed to possibly avoid surgery in the first place. Medical 
experts confirm that adjustments & stretches could have avoided surgery & discharge. Soldier 
wanted a career out of Army—was in almost 10 yrs-hoped for 20. Entire life was altered 
because of surgery & wrong return to duty after. I still cannot live a normal life—need help 
with housework & job performance severely hindered by disability & 3 surgeries.” The CI made 
additional comments in remarks block of the application which the Board took into 
consideration. 

 

 

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 rating for the unfitting back condition is 
addressed below; and, no additional conditions are within the DoDI 6040.44 defined purview of 
the Board. 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 
Service Board for Correction of Military Records. The Board acknowledges the CI’s opinion that 
a medical error contributed to her disability. It is noted for the record that the Board has no 
jurisdiction to investigate or render opinions in reference to such allegations; and, redress in 
excess of the Board’s scope of recommendations (as noted above) must be addressed by the 
Board for Correction of Military Records and/or the United States judiciary system. 

 

 

 


RATING COMPARISON: 

 

Service IPEB – Dated 20020514 

VA - (2 Mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

CHRONIC LOW BACK PAIN 
DUE TO LUMBAR DDD, S/P 
L5-S1 LAMINECTOMY AND 
DISCECTOMY 

5299-5295 

10% 

DDD, LUMBAR SPINE, S/P L5-S1 
LAMINECTOMY AND 
DISCECTOMY 

5293-
5292* 

20% 

20021107 

No Additional MEB/PEB Entries 

Other x 0 

20021107 

Combined: 10% 

Combined: 20% 



Derived from VA Rating Decision (VARD) dated 20030103 (most proximate to date of separation [DOS]). * Code changed to 
5243 by VARD of 20100206. 

 

 

ANALYSIS SUMMARY: The Board acknowledges the CI’s information regarding the significant 
impairment with which her service-connected condition continues to burden her; but, must 
emphasize that 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 
Department of Veteran Affairs operating under a different set of laws. The 2002 VASRD coding 
and rating standards for the spine, which were in effect at the time of the CI’s separation, were 
updated 23 September 2002 for code 5293 (incapacitating episodes), and then changed to the 
current §4.71a rating standards on 26 September 2003. The 2002 standards for rating based on 
range-of-motion (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. VASRD normal ROM values were not in effect prior to 26 September 2003, and are 
for the combined thoracolumbar spine segment, whereas the older spine criteria considered 
the thoracic and lumbar spine segments separately. For the reader’s convenience, the 2002 
rating codes under discussion in this case are excerpted below. 

 

5285 Vertebra, fracture of, residuals: 

With cord involvement, bedridden, or requiring long leg braces 100 

Consider special monthly compensation; with lesser 

involvements rate for limited motion, nerve paralysis. 

Without cord involvement; abnormal mobility requiring neck 

brace (jury mast)............................................ 60 

In other cases rate in accordance with definite limited motion 

or muscle spasm, adding 10 percent for demonstrable deformity of vertebral body. 

 

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 osteoarthritic 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 

 

Chronic Low Back Pain. The narrative summary (NARSUM) indicated chronic radicular LBP 
continued following L5-S1 left laminectomy and diskectomy in May 2001 (16 months prior to 


separation). At the MEB exam, the CI reported LBP with chronic radiation into the left leg and 
intermittent into the right leg. She noted some paresthesias of the top of the left foot greater 
than the right foot. The MEB physical exam noted full active ROM of the spine to flexion, 
extension, and lateral bending. The left lower lumbar area was tender. The motor (5/5) and 
sensory exams were normal, and the scar was well healed. The left Achilles tendon reflex was 
decreased to 1/4 with all other lower extremity reflexes symmetric and normal at 2/4. 
Magnetic resonance imaging (MRI) of the LS-spine showed no recurrent herniated disk, but did 
show a possible lateral recess stenosis on the right. Electromyogram (EMG) and nerve 
conduction velocity studies were normal. 

 

At the VA Compensation and Pension (C&P) exam performed 2 months after separation, the CI 
reported continued lower back pain with “legs tingle and ache and go numb in the evenings.” 
She frequently had pain that required her to stop what she was doing. Exam stated “Range of 
motion - she can forward flex and the fingers touch the floor without difficulty, which is about 
65 degrees. She can extend approximately 25 degrees. Right lateral bending is approximately 
25-30 degrees. Left lateral bending is approximately 25-30 degrees. I don't see any significant 
pain with motion. … The strength is decreased on the left leg when compared to the right.” 
Sensory and reflex exams were normal. Radiographs demonstrated sacralization of L5 and 
narrowing of the L4/5 disc space. VA records indicate additional back surgeries in January 2009 
and January 2010 for increased pain in the lower back and left lower extremity; with 
subsequent VA 20% rating for lumbar radiculopathy, left lower extremity (8799-8720) effective 
February 2009. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rating of 10% was analogous to 5295 (lumbosacral strain), and the 10% criteria is “With 
characteristic pain on motion.” The VA 20% rating was coded 5293-5292 (Intervertebral disc 
syndrome and limitation of lumbar spine motion) with the rating decision indicating 20% 
granted for “moderate limitation of the lumbar spine.” The remote additional surgeries and 
increased symptoms were considered post-separation worsening, and not indicative of the CI’s 
disability picture proximate to separation. The Board noted that current VASRD thoracolumbar 
normal ROMs were not in effect at the time of separation. Lumbar ROM normal values were 
not specified by the VA examiner; however, historic norms were from forward flexion of 60 
degrees to 90 degrees depending on measurement technique, with lateral flexion from 25 
degrees to 30 degrees as normal. The Board noted the VA examiner’s description included “the 
fingers touch the floor without difficulty” which did not support a moderate limitation of 
lumbar ROM. The Board considered rating under 5293 for radicular symptoms, despite normal 
electrophysiologic testing and deliberated if symptoms more nearly met the “mild” (10%) 
criteria or the “moderate; recurring attacks” (20%) criteria. 

 

The Board considered the absent left ankle reflex noted in the exam and the left lower 
extremity weakness in the VA exam with consideration of the radicular pain symptoms 
portrayed a disability picture closer to that envisioned by the 20% 5293 rating criteria. 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 low back condition, coded 5295-5293. 

 

 

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 low back condition, the Board unanimously recommends a 
disability rating of 20%, coded 5295-5293 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 her prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Chronic Low Back Pain Due to Lumbar DDD, S/P L5-S1 
Laminectomy and Discectomy 

5295-5293 

20% 

COMBINED 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120529, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxxxxxxx, AR20130009598 (PD201201587) 

 

 

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 xxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)