RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1200471 SEPARATION DATE: 20030504 

BOARD DATE: 20130220 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an Active Guard/Reserve SSG/E-5 (92Y20/Unit Supply Specialist), 
medically separated for chronic low back pain (LBP). The chronic LBP condition could not be 
adequately rehabilitated for the CI to improve to meet the physical requirements of his Military 
Occupational Specialty (MOS) or satisfy physical fitness standards. The CI was issued a 
permanent L3 profile and referred for a Medical Evaluation Board (MEB). The MEB forwarded 
chronic LBP, chronic S1 radiculopathy to the Physical Evaluation Board (PEB) for adjudication. 
The PEB adjudicated the chronic LBP condition as unfitting, rated 20%, with application of the 
Veterans Affairs Schedule for Rating Disabilities (VASRD). The CI made no appeals, and was 
medically separated with a 20% disability rating. 

 

 

CI CONTENTION: “Conditions rated by the Physical Evaluation Board (PEB) were more severed 
(sic) than originally rated by (PEB). PEB originally rated both conditions: (post L-5 S-I 
DISECTOMY and RIGHT S1 RADlCULOPATHY) at 20%. The Veterans administration Rated (post 
L-5 S-l D1SECTOMY at 20%, and the RIGHT S1 RADICULOPATHY at 10% on their first rating dated 
June 14 2004. Consequently, On a rating dated Ju1 21st, 2005, the Veterans administration 
increased the Right Lower extremity S1 Radiculopathy to a 20%, and the L-5 S-1 Discectomy at 
40%. (See Ratings attached)” 

 

 

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. The chronic LBP condition as requested for 
consideration meets the criteria prescribed in DoDI 6040.44 for Board purview; and, are 
addressed below. The other requested conditions are 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 20021218 

VA (10 Mos. Post-Separation) – All Effective Date 20030505 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Low Back Pain s/p 
Diskectomy w/ 
Radiculolopathy 

5299-5295 

20% 

DDD Lumbar Spine s/p Discectomy 

5242 

20%* 

20040306 

Radiculopathy, Rt Lower Extremity 

8520 

10% 

20040306 

.No Additional MEB/PEB Entries. 

Other VA Conditions 

20040306 

Not Service-Connected x 9 

20040306 

Combined: 20% 

Combined: 90% 



*VA rating for back under current §4.71a guidelines; increased to 40% effective 20050404 


 

 

ANALYSIS SUMMARY: 

 

Chronic Low Back Pain Condition. 

The MEB narrative summary (NARSUM), dated 8 November 2002, noted chronic LBP radiating 
down the right lower extremity since the CI sustained a back injury in November 2000 while 
lifting a heavy object. The CI returned to duty, but continued to complain of back pain 
aggravated by standing, walking, repeated bending, running and climbing stairs. Magnetic 
resonance imaging (MRI) demonstrated a herniated disk and the CI subsequently underwent 
surgery (L5-S1 discectomy) in December 2001. Electrodiagnostic investigation in October 2002 
evidenced right S1 radiculopathy. The right leg pain increased after surgery and conservative 
treatment was not effective, subsequent neurosurgical consult recommended lumbosacral 
fusion. The CI declined the option and was referred to the MEB, and was unable to perform 
basic tasks required by his MOS. The MEB physical exam noted the lumbar spine range-of-
motion (ROM) to be reduced (flexion 45 degrees, extension 20 degrees, right lateral flexion 20 
degrees) and associated with pain in the low back and right leg. The Achilles reflex was slightly 
reduced on the right side and patellar reflexes were normal bilaterally. Pinprick and light touch 
sensation were intact and symmetric from L2-S1. Muscle strength was normal for hip and leg 
muscles. Plantar flexion of the right foot could not be assessed accurately secondary to pain. 
Straight leg raise (SLR) increased numbness on the right, reverse SLR was negative. The gait 
was described as tandem with a slight limp on the right side. Neurosurgical consultation on 
13 January 2003 documented 20% reduction in flexion, 30% reduction in extension, and 15% 
reduction in rotation. There were examination findings of right sided radiculopathy including 
positive SLR, slight weakness of plantar flexion, and some decreased sensation. The 
neurosurgeon noted an MRI dated 29 November 2002, showing degenerative disc disease 
(DDD), epidural fibrosis affecting the right S1 nerve root, and recurrent disc displacement and 
offered additional surgery. At the VA Compensation and Pension examination 27 February 
2004, 10 months after separation, the lumbar spine ROM was further limited to 30 degrees 
forward flexion, 10 degrees back extension, 20 degrees lateral rotation and bending. SLR was 
negative. Examiner diagnosed the CI with degenerative disc disease of the lumbar spine status 
post discectomy with residual sciatica on the right lower extremity. A second exam performed 
in March 2004 noted pain radiating down the right lower extremity into the posterior aspect of 
the tight calf and heel. 

 

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 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. 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 low back 
condition at 20% coded 5295 (lumbosacral strain) citing presence of the associated right 
radiculopathy. The VA under the current VASRD guidelines which became effective after the 
CI’s separation from service, rated separately the thoracolumbar condition 20% based on the 
moderate limitation of motion (5242) and the right lower leg radiculopathy 10% considering 
mild incomplete paralysis below the knee. 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 examination supported a 20% rating, moderate, under the 
VASRD diagnostic code 5292 in effect at the time of separation. The CI had a chronic condition, 


and the preponderance of evidence more nearly approximated the moderate limitation than 
the severe. The Board next considered whether a higher rating was warranted under the 
guidelines for intervertebral syndrome, code 5293, however there were no 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 than the 20% rating. There was characteristic pain on motion and 
muscle spasm but no other required criteria for a 40% disability rate. The Board also 
considered if additional disability rating was justified for peripheral nerve impairment due to 
radiculopathy. The CI had a herniated disc with radicular pain treated with surgery. He had 
persisting right sided radicular pain following surgery related to scarring and recurrent disc 
disease. Examinations indicated normal strength. There was a slight right limp and SLR 
produced radiating pain. The presence of functional impairment with a direct impact on fitness 
is the key determinant in the decision to recommend any condition as additionally unfitting. 
Therefore the critical decision is whether or not a significant motor weakness impacted MOS 
activities. There is no evidence in this case that motor weakness existed to any degree that 
could be described as functionally impairing. The Board therefore concludes that additional 
disability rating is not justified on this basis. 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 
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. In the matter of the 
chronic LBP 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 

5299-5295 

20% 

COMBINED 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120612, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 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 xxxxxxxxxxxxxxxxxx, AR20130005357 (PD201200471) 

 

 

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)