RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXXX CASE: PD1200627 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130308 

SEPARATION DATE: 20020815 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (92/Parachute Rigger), medically separated 
for mid thoracic back pain with a mild compression fracture of T8 and Schmorl’s nodes. The 
thoracic back condition could not be adequately rehabilitated to meet the physical 
requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards. 
He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). The 
MEB also identified and forwarded chronic right hip pain and somatic dysfunction of the 
cervicothoracic and rib area IAW AR 40-501 for Physical Evaluation Board (PEB) adjudication. 
Both conditions were judged to meet retention standards. The PEB adjudicated “chronic mid 
thoracic back pain…with mild compression fracture of T8 with Schmorl’s nodes T6-T9” as 
unfitting, rated 10%, citing criteria from the Veteran’s Affairs Schedule for Rating Disabilities 
(VASRD). The remaining conditions were determined to be not unfitting and therefore not 
ratable. The CI made no appeals and was medically separated a 10% disability rating. 

 

 

CI CONTENTION: “From the original date of discharge I was rated at 0% for right hip, however 
that has been changed to 10% and the 10% for T6-T9 Compression factor was changed to 20% 
with secondary insomnia would have given me a rating of 30%. Later I was disapproved for 
hearing loss and Tinnitus (ring in my ears) which I believe was caused by being around aircraft 
on flight lines for years as a parachute rigger. I also believe my original rating of 10% for my 
back injury should have been higher. The army never took into consideration the secondary 
Insomnia as part of my injury. I currently still can't sleep laying down without waking up after 
only a couple of hours. Most of the time I have to sleep in a recliner in a more upright position. 
I continue to wake up in severe pain every morning do to this injury. I even purchased an 
adjustable bed, but even that has not helped. I continually have to see a chiropractor for my 
back. I have been referred to a Orthopedic Surgeon do to a disk replacement surgery because I 
have a disk bulging in my low back, which I believe is from my original jump injury. I am 
attaching a page from my original Medical records dated from the time of that jump, 
complaining of low back pain that was not looked into more then giving me anti-
inflammatories's. This would have been two areas of my back that was injured and should have 
been evaluated together. This injury has effected every part of my day to day life. I was having 
migraine headaches before I got out and that was not included in the original board findings. I 
also have an issue with being intimate with my spouse. No matter what position I can't handle 
having sex do to the pain it causes. With the lack of sleep I go through everyday I have to nap 
off and on all through my days off, just to catch up some on my sleep so I can work. Even 
though I do work, I routinely miss work due to the pain that I experience. I respectfully request 
the board to change my discharge from Disability Severance, to Medically Retired.” 

 

 

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 thoracic spine 
condition is addressed below. The Board acknowledges the CI’s contention for a rating of his 
right hip condition which was determined to be not unfitting by the PEB; and, emphasizes that 
disability compensation may only be offered for those conditions that cut short the member’s 
service career. Should the Board judge that any contested condition was most likely 
incompatible with the specific duty requirements; a disability rating IAW the VASRD, and based 
on the degree of disability evidenced at separation, will be recommended. The CI did not 
specifically contend for the not unfitting somatic dysfunction of his cervicothoracic and rib 
areas. However, his contention is sufficiently broad that the Board determined this to be within 
its scope. Hearing loss, tinnitus, insomnia, migraine headaches and sexual dysfunction were not 
identified by the MEB, and thus are not 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 Army Board for 
Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20020612 

VA - (1 Mos. Pre-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Mid Thoracic Pain 
w/Compression Fracture 
with Schmorl’s Nodes 

5299-5295 

10% 

T6 Compression Fracture 
w/Insomnia 

5285-5291 

20% 

20020709 

Right Hip Pain 
(trochanteric bursitis) 

Not Unfitting 

Right Hip Greater Trochantitis 

5252 

0%* 

20020709 

Somatic Dysfunction of 
Cervico-thoracic and rib 
areas 

Not Unfitting 

No VA Entry 

No Additional MEB/PEB Entries 

Other x 3 

20020709 

Rating: 10% 

Rating: 20% 



Derived from VA Rating Decision (VARD) dated 20020729. *Rating increased to 10% effective 20060213 

 

 

ANALYSIS SUMMARY: The Board acknowledges the CI’s information regarding the significant 
impairment with which his service-connected condition continues to burden him; but, must 
emphasize that the Disability Evaluation System (DES) has neither the role nor the authority to 
compensate service 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 Veterans Affairs (DVA), operating under a different set of laws. The Board 
considers DVA evidence proximate to separation in arriving at its recommendations; and, DoDI 
6040.44 defines a 12-month interval for special consideration to post-separation evidence. 
Post-separation evidence is probative to the Board’s recommendations only to the extent that 
it reasonably reflects the disability at the time of separation. The Board acknowledges the CI’s 
assertions that his disability disposition was incomplete and did not include his insomnia. 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 respective BCMR and/or the United States judiciary 
system. 

 

The CI first sought treatment for back pain in April 1999. His initial complaints were of low back 
pain (LBP) and then upper thoracic pain. No acute trauma was reported although his pain 
started a few days after a parachute jump. An X-ray of the thoracic spine was normal as was a 
scoliosis survey. A bone scan showed a slight deficiency at T8 of “doubtful clinical significance.” 


He was treated conservatively and returned to jump status. In addition, his NCOER noted that 
he scored a 285 on his Army physical fitness test and was a team member in a 120 mile relay 
run, placing third overall. He apparently did well until he was involved in a low speed motor 
vehicle accident (MVA) in early February 2001 which exacerbated his pain after his car was rear 
ended. He was noted to have stable Schmorl nodes with a slight decrease in vertebral body 
height at T9 or T9, but without acute findings on thoracic X-rays. He was diagnosed with strain 
and treated with a trigger point injection and Motrin. He was seen multiple times the next few 
months for persistent pain and treated with medications and osteopathic manipulation with 
some improvement. A bone scan on 10 May 2001 showed decreased activity from T6-9, as well 
as both shoulders and acromio-clavicle joints. A 14 September 2001 note documented that he 
was on morphine for help sleeping and that he currently also had hip complaints, but no 
neurological symptoms. It also noted that litigation was pending. At his final clinical 
appointment, 9 months prior to separation and 9 months after the MVA, in physical therapy, he 
was noted to have full flexion of the back with painful lateral bending. Hip flexion was reduced 
and painful. He was noted to have muscle spasm secondary to tight hamstrings and the 
paravertebral muscles. He was seen at the VA 10 months after separation and noted to have 
normal joints and “adequate” range-of-motion (ROM) of the spine with spasm on the right and 
tenderness on the left thoracic region. An X-ray showed a “suggestion of a very mild 
compression deformity at T9 of indeterminate age”. A follow-up magnetic resonance imaging 
(MRI) exam 2 weeks later was normal. 

 

Thoracic Spine Condition. The narrative summary (NARSUM) was dictated on 2 May 2002, 3 
months prior to separation. The CI reported back pain since the 1999 parachute jump. He 
noted that, after treatment, he was able to return to duty until the MVA in February 2001. His 
pain prevented him from lifting more than 30 to 40 pounds and running and was exacerbated 
by lifting his left arm overhead. He also reported intermittent numbness and tingling in his left 
hand and pain in his left arm and hand when his back flared. He was able to transfer from 
standing to sitting to prone and reverse without difficulty. Gait was normal as was heel-toe 
ambulation. Lumbar ROM was normal. No scoliosis was observed. No atrophy was present. 
The spinous processes were tender to palpation T5-9. Provocative testing of the peripheral 
nerves of the upper extremities was negative. Motor strength was normal in the upper and 
lower extremities. The ROM obtained a month earlier showed 73 degrees of flexion, 25 
degrees of extension, right side bend from 5 -17 degrees and left side bend from (-) 5 to 10 
degrees. It is not clear if this was strictly thoracic or both thoracolumbar motion. At the VA 
Compensation and Pension (C&P) exam performed a month prior to separation, the CI reported 
daily pain exacerbated by bending and lifting heavy objects. There was normal station and gait 
as well as spinal curvature. The CI was tender T7-10, but without spasm. Flexion was 50, 
extension 40, and rotation 30 left and right with discomfort on the right. Again, the examiner 
did not specify if this was combined or limited to thoracic spine motion. The neurological 
examination was normal. The Board directs attention to its rating recommendation based on 
the above evidence. The PEB rated the thoracic spine pain at 10%, coding it analogously to 
5295, lumbosacral strain. The VA rated the back at 20% for a T6 compression fracture with 
associated insomnia as 5285-5291, for vertebral fracture and limitation of motion, citing the 
insomnia and evidence of vertebral body deformity secondary to the fracture. The Board noted 
that the limitations of ROM were minimal and that neither examiner specified if the ROM was 
due solely to the thoracic spine or to the combined thoracic lumbar segments. However, there 
was clearly a decrease in the ROM. It was noted, though, that a physical therapy examination 9 
months after the MVA noted normal ROM. The CI was able to return to jump status after the 
initial 1999 injury and had an outstanding score on his physical fitness test. An X-ray performed 
after the MVA showed no acute changes compared to a prior study and a MRI almost a year 
after separation was normal. Nonetheless, imaging did demonstrate a compression fracture at 


T9. 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 back condition 
utilizing code 5291 for limited ROM and another 10%, citing code 5285, for a demonstrable 
deformity of a vertebral body for an added disability rating of 20%. 

 

Contended PEB Conditions. The Board’s main charge is to assess the fairness of the PEB’s 
determination that the right hip pain and somatic dysfunction of the cervicothoracic and rib 
areas were not unfitting. The Board’s threshold for countering fitness determinations is higher 
than the VASRD §4.3 (reasonable doubt) standard used for its rating recommendations, but 
remains adherent to the DoDI 6040.44 “fair and equitable” standard. The CI did have a profile 
for both chronic back pain and right hip pain. The back pain was implicated in the commander’s 
statement, but not the hip pain. Neither condition was judged to fail retention standards. The 
CI was seen for the hip pain only in concert with the thoracic spine pain. The somatic 
dysfunction of the cervicothoracic and rib areas is a description rather than a diagnosis and only 
appears in the NARSUM. Both conditions were reviewed by the action officer and considered 
by the Board. There was no performance based evidence from the record that either of these 
conditions significantly interfered with satisfactory duty performance and would have been 
found unfitting in the absence of the thoracic spine pain condition. After due deliberation in 
consideration of the preponderance of the evidence, the Board concluded that there was 
insufficient cause to recommend a change in the PEB fitness determination for the contended 
conditions and so no additional disability ratings are recommended. 

 

 

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 thoracic spine condition, the Board unanimously 
recommends an added disability rating of 20%, coded 5285 at 10% and 5291 at 10%, IAW 
VASRD §4.71a. In the matter of the contended right hip and somatic dysfunction of the 
cervicothoracic and rib areas, the Board unanimously agrees that it cannot recommend either 
for additional disability rating and recommends no change from the PEB determinations as not 
unfitting. 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 his prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Chronic mid thoracic back pain 

5285-5291 

10 + 
10% 

ADDED 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120606, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 


 

 

 

xxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 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 xxxxxxxxxxxxxxxxxxxxxxxx, AR20130007499 (PD201200627) 

 

 

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 xxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)