RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXX CASE: PD1201671 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130508 

SEPARATION DATE: 20021206 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (62B2/Heavy Equipment Mechanic and 
71L/Administrative Specialist) medically separated for a low back condition. Her low back pain 
(LBP) began after epidural placement during a C-section in 1997. Despite extensive treatment 
the 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 back condition, 
characterized as “chronic low back pain” and “mild chronic degenerative changes at the lumbar 
vertebra L2 and L3,” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No 
other conditions were submitted by the MEB. The PEB adjudicated the low back condition as 
unfitting, rated 0% with likely application USAPDA pain policy. The CI made no appeals, and 
was medically separated with that disability rating. 

 

 

CI CONTENTION: The CI’s spouse elaborated no specific contention in the application on her 
behalf. 

 

 

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 low 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. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20020808 

VA - (10 Mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Mechanical Low Back Pain Post Epidural for 
Delivery…Mild Degenerative Changes L3-L5 w/ no 
Herniated Nucleus Pulposus 

5299-
5295 

0% 

DJD Lumbosacral 
Spine w/ Residuals 

5242 

10%* 

20031027 

No Additional MEB/PEB Entries 

Other x 1 

20031027 

Combined: 0% 

Combined: 10% 



*20060608 VARD increases DJD to 20% effective 20060124. 

 

 

ANALYSIS SUMMARY: 

 

Low Back Pain Condition. The narrative summary (NARSUM) notes documented the CI 
underwent a labor epidural placement during a C-section in May 1997 and subsequently had 
continuous LBP. She was evaluated and treated extensively over 5 years by pain services, 
physical therapy, anesthesia, Physical Medicine & Rehabilitation (PM&R), occupational therapy, 


and surgery, for a breast reduction, with some improvement but not elimination of her pain. 
There was no indication for surgical intervention. The permanent profile identified the 
condition with the following documented limitations, no prolonged standing greater 30 
minutes without a 15 minute break, no ruck marching, lift up to 30 pounds, march up to 2 
miles, able to perform alternate walk, push-ups, and sit-ups for physical fitness testing, and able 
to train at own pace and distance. The commander’s statement corroborated her limitations 
and documented she could perform the reassigned duties as the unit’s Retention/Legal NCO 
however could not perform her PMOS which required constant bending, twisting, and turning 
and weight requirements. 

 

The MEB physical exam, 4 months prior to separation, demonstrated a height of 62 inches, a 
weight of 180 pounds, flexion to 18” from the floor and full, full active range-of-motion (ROM) 
with lateral bending and twisting, negative signs for disc disease, normal neuromuscular 
findings of the lower extremities, normal gait, no spams and negative Waddell’s’ signs. X-rays 
demonstrated multilevel degenerative changes of the lumbar spine. Computer Tomography 
(CT) scan of the lumbar spine revealed mild degenerative changes on the anterior aspect of the 
L3 through L5 vertebra with no evidence of herniated nucleus pulposus or spondylolisthesis. At 
the VA Compensation and Pension (C&P) exam performed 10 months after separation, the CI 
reported constant, non-radiating, throbbing back pain around the belt line with a 3 of 10 in 
intensity. The pain worsened with prolonged standing and was severe 3 times in the last year 
which caused her to miss attendance 3 days at her full-time school. Bed rest helped alleviate 
the pain. She also reported the use of a back brace 1-2 times per month and took a non-
steroidal anti-inflammatory medication every other day for pain relief. The C&P exam 
demonstrated no Deluca observations, spasms, or posture abnormalities and normal 
neuromuscular findings of the lower extremities. 

 

The goniometric ROM evaluations in evidence which the Board weighed in arriving at its rating 
recommendation, with documentation of additional ratable criteria, are summarized in the 
chart below. 

 

Thoracolumbar ROM 

(Degrees) 

PT ~28 Mo. Pre-Sep 

(20000816) p.513 

MEB ~ 6 Mo. Pre-Sep 

(20020611) p.28 

VA C&P ~ 10 Mo. Post-Sep 

(20031027) p.149 

Flexion (90 Normal) 

60 

18” away from floor 

70 

Extension (30) 

50 

Full AROM – “full 
complete lateral bending 
and twisting of spine” 

25 

R Lat Flexion (30) 

50 

25 

L Lat Flexion (30) 

50 

25 

R Rotation (30) 

 

30 

L Rotation (30) 

 

30 

Combined (240) 

 

 

205 

Comment 

Silent to painful motion 

 

Normal gait; no palpable 
spasms 

 

Painful at extremes of 
forward flexion; no evidence 
spasms 

§4.71a Rating 

 

 

10% 

Old spine 5292 

10% 

10% 

 



 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB based its rating recommendation IAW 2002 VASRD coding and rating standards for the 
spine, which were in effect at the time of separation, which were modified on 23 September 
2002 to add incapacitating episodes (5293, Intervertebral disc syndrome), and then 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. The 
two potentially applicable codes from the 2002 VASRD are excerpted below: 

 


5292 Spine, limitation of motion of, lumbar: 

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

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

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

 

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 USAPDA pain policy for rating, and its 0% 
determination was inconsistent with §4.71a standards. The 20% rating for 5295 is fairly 
specifically defined as noted 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 PT examinations. 
The Board also considered a rating under the 5292 code for limitation of spine motion. The 
mildly impaired ROM documented by the MEB and PT exam would justify a “slight” 10% rating 
under that code especially in lieu of the CI’s body habitus which the medical member discussed 
is likely contributing to the forward flexion limitation. The VASRD §4.71a rating standards were 
in effect at the time of the VA exam which documented painful flexion and a combined ROM 
limitation of motion consistent with the 10% rating and nothing higher. There is 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 recommends a disability rating of 10% for the LBP 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 USAPDA pain policy for rating low 
back pain condition was operant in this case and the condition was adjudicated independently 
of that policy by the Board. In the matter of the low back pain condition, the Board 
unanimously recommends a disability rating of 10%, coded 5292 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 

Mechanical Low Back Pain 

5292 

10% 

COMBINED 

10% 



 

 

 

 

 


The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120924, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxx, 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 xxxxxxxxxxxxxxxxxxxxxxxxx, AR20130011071 (PD201201671) 

 

 

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 10% 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 xxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)