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AF | PDBR | CY2012 | PD-2012-00489
Original file (PD-2012-00489.pdf) Auto-classification: Denied
RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

SEPARATION DATE:  20030801 

 
NAME:  XXXXXXXXXXXXXXXX                                                              BRANCH OF SERVICE:   ARMY 
CASE NUMBER:  PD1200489 
BOARD DATE:  20130109 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty SGT/E‐5 (52C/Utilities Equipment Repairer), medically 
separated for lumbosacral strain with left sciatic dysfunction.  The CI first noted low back pain 
(LBP)  in  1997  after  lifting  heavy  gas  cylinders.    He  was  found  to  have  a  herniated  nucleus 
pulposus (HNP) associated with left sciatic dysfunction.  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 E2 profile 
and  referred  for  a  Medical  Evaluation  Board  (MEB).    The  MEB  forwarded  lumbar  spine, 
herniated disc pulposus, to the Physical Evaluation Board (PEB) for adjudication.  Adjustment 
disorder, vision defect, intermittent retropatellar pain syndrome (RPPS) of the left knee, mild 
asymptomatic  pes  planus,  mild  (bilateral)  high  frequency  hearing  loss  (HFHL)  and  occasional 
heartburn,  identified  in  the  rating  chart  below,  were  forwarded  by  the  MEB  as  conditions 
meeting  retention  standards.    The  PEB  adjudicated  the  lumbosacral  strain  and  left  sciatic 
dysfunction  conditions  as  unfitting,  rated  10%  each,  with application  of  the  Veteran’s  Affairs 
Schedule for Rating Disabilities (VASRD).  The remaining conditions were determined to be not 
unfitting.  The CI made no appeals and was medically separated with a 20% disability rating.   
 
 
CI  CONTENTION:    “Conditions  at  time  of  discharge  have  since  then  developed  into  further 
medical conditions.”  The CI made no specific contention in his application.   
 
 
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 IPEB – Dated 20030627 

VA (<1 Mo. Pre‐Separation) – All Effective Date 20030802

Condition 

Lumbosacral strain 
L sciatic dysfunction 
Adj disorder 
RPPS L knee 
Heartburn 
Mild Bil HFHL 
Vision defect 
Mild asy pes planus 

Code 

5293 5299‐5295 

5293‐8620 

Rating
10%
10%

Not Unfitting 
Not Unfitting 
Not Unfitting 
Not Unfitting 
Not Unfitting 
Not Unfitting 

↓No Addi(cid:415)onal MEB/PEB Entries↓ 

Combined:  20% 

 

Condition

HNP lumbar
Left sciatic dysfunction
Adjustment disorder
L knee, RPPS
Heartburn
NO VA ENTRY
NO VA ENTRY
NO VA ENTRY
R shoulder subacromial bursitis
L shoulder subacromial bursitis

Code 

5293‐5292 
5293‐8620 

9440 

5099‐5014 
7399‐7319 

5019 
5019 

0% X 4 / Not Service‐Connected x 1 

Combined:  50% 

Rating 
20% 
10% 
0% 
10% 
NSC 

 
 
 

10% 
10% 

Exam

20030718
20030718

STR

20030718
20030718

20030718
20030718
20030718
20030718

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  Department  of  Veterans  Affairs  (DVA)  but  not 
determined to be unfitting by the PEB.  However the 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 the 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.   
 
Lumbosacral strain and left sciatic dysfunction condition.  The first record in evidence for LBP 
was in late October 1999 when the CI presented with a 3 week history of pain after repetitive 
lifting.  He was referred to physical therapy (PT) where normal range‐of‐motion (ROM) and gait 
were  noted  although  his  symptoms  increased  with  ROM.    He  was  treated  with  PT  and 
medications, but had recurrent symptoms over the next year.  On 12 September 2000, he was 
found  to  have  a  left  lateral  disc  protrusion  at  L5S1  with  left  foraminal  stenosis  on  magnetic 
resonance imaging (MRI) examination.  He was seen in orthopedics and given duty limitations 
and referred back to PT.  He continued conservative management, but had persistent pain and 
was referred to Physical Medicine and Rehabilitation (PMR) on 2 April 2001.  The neurological 
examination  and  ROM  were  normal.    He  was  referred  to  an  MOS  Medical  Retention  Board 
(MMRB)  and  retention  with  duty  limitations  recommended.    On  25  February  2003,  an 
orthopedist  noted  a  normal  gait  and  neurological  examination  with  a  positive  test  for  nerve 
root  irritation  and  tenderness  in  the  lumbar  region.    X‐rays  were  normal.    He  was  issued  a 
permanent L3 profile and referred to MEB.  On 11 April 2003, he was placed on quarters for 72 
hours; this is the only record of quarters found in evidence.  He was seen again in orthopedics 
on 17 April 2003 and gave a history of LBP radiating to both calves.  An MRI was repeated on 
30 April 2003 and showed left L5S1 disc protrusion with mild lateral recess narrowing adjacent 
to the left S1 nerve root and disc bulging at L3‐4 and L4‐5.  At the MEB examination on 22 April 
2003, the CI reported numbness and tingling in both legs and that the LBP radiated to both legs.  
On  examination,  he  had  tenderness  at  the  lumbo‐sacral  junction  without  spasm  and  slightly 
reduced  flexion,  extension  as  well  as  left  lateral  bend  and  rotation.    Testing  for  nerve  root 
irritation was negative.  One non‐organic sign of pain was present.  Mild weakness of left ankle 
dorsiflexion  was  noted  as  was  diminished  sensation  in  a  S1  distribution.    At  an  orthopedic 
evaluation on 28 May 2003, obtained for the MEB, the CI reported progressive LBP since 1999 
which had been treated with epidurals, PT and other conservative management without relief 
of his pain.  On examination, he was found to have spasm and tenderness in the lower lumbar 
spine area with slight instability and a slight decrease in ROM.  Testing for nerve root irritation 
was slightly positive on the right.  Strength and sensation were grossly normal.  Reflexes were 
symmetric.    The  narrative  summary  (NARSUM)  dictated  on  5  June  2003,  2  months  prior  to 
separation.  It noted the above and that the CI could not run, bend, twist, lift heavy objects or 
stand over 30 minutes without aggravation of his pain.  He was also limited to sitting no more 
than an hour and walking no more than 40 minutes.  It cited the both the above examinations 
for objective findings.  It noted that the ROM was slightly reduced in flexion, extension and left 
rotation and side bend.  At the VA Compensation and Pension (C&P) examination on 18 July 
2003, 2 weeks prior to separation, the CI reported a lot of pain if he sat in one place over 15 
minutes or drove over 30 minutes and a past history of foot drop on the left.  Gait and posture 
were noted to be normal without foot drop although with reversal of normal lumbar lordosis.  
Episodic spasms were noted.  The ROM was reduced to 70 degrees in flexion and another ten 
degrees after repetition due to spasms and pain.  A radiculitis at L5S1 was noted.  Provocative 

   2                                                           PD1200489 
 

testing for nerve root irritation was positive on the left at 70 degrees.  Some weakness at 4/5 
was noted for dorsiflexion of the left great toe.  X‐rays were normal.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  and  VA  both  rated  the  left  sciatic  dysfunction  at  10%,  coding  it  5293‐8620,  for 
intervertebral disc syndrome and sciatic neuritis.  The Board noted that both the MEB and C&P 
examiners  noted  slight  weakness  of  left  ankle  dorsiflexion,  but  that  the  orthopedist  did  not.  
The C&P examiner specifically noted the gait to be normal without foot drop.  This supports no 
more than a mild disability.  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  left  sciatic  dysfunction  condition.    The 
Board then considered the rating for the L5S1 HNP.  The PEB coded the condition as 5293 and 
5299‐5295, analogous to lumbosacral strain, and rated it 10%.  The VA coded it 5293 and 5292, 
limitation of motion, but rated it at 20% for moderate limitation of motion.  The Board noted 
that the ROM seen on the C&P examination was decreased from that seen on the two MEB 
examinations, both of which showed only a slight decrease.  The Board considered that the C&P 
examination was more proximate to separation, but that the orthopedic examination was by a 
more  experienced  examiner  and  only  one  month  earlier  and  supported  by  the  other  MEB 
examination.    It  was  therefore  assigned  a  higher  probative  value.    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 HNP 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 HNP and left sciatica conditions and IAW VASRD §4.71a 
and 4.124, 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:   
 

VASRD CODE 
5293‐5299‐5295 

5293 8620 

COMBINED 

RATING

10%
10%
20%

UNFITTING CONDITION

Herniated Disc Pulposus L5/S1 with some Left Sciatica
Left Sciatic Dysfunction 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120604, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 

           XXXXXXXXXXXXX, DAF 
           President 
           Physical Disability Board of Review 

   3                                                           PD1200489 
 

SFMR‐RB 
 

 

 
 

 

 

 
 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency  

(TAPD‐ZB / XXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202‐3557 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 

XXXXXXXXXXXXXXXXXX, AR20130000823 (PD201200489) 

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 

 

 

 

 

 

 

 

 

 

 

 

 

     XXXXXXXXXXXX 

     Deputy Assistant Secretary 
         (Army Review Boards) 

 

 

 
CF:  

(  ) DoD PDBR 

(  ) DVA 

 

 

 

   4                                                           PD1200489 
 



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