RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201287 SEPARATION DATE: 20020704 

BOARD DATE: 20130213 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (19D/Scout) medically separated for chronic 
thoracic and lumbar back pain. He was treated, but was unable to fully perform his military 
duties, or meet physical fitness standards. He was issued a permanent L3 profile and 
underwent a Medical Evaluation Board (MEB). The MEB found his back condition (scoliosis) 
medically unacceptable, and referred him to an Informal Physical Evaluation Board (IPEB). No 
other conditions were listed on DA Form 3947. The IPEB found the chronic back pain condition 
unfitting, but determined that it existed prior to service (EPTS), and had followed a course of 
natural progression without permanent service aggravation. The CI did not accept the IPEB 
findings and demanded a formal hearing. The Formal PEB (FPEB) found the chronic back pain 
condition unfitting, and rated it 10%. The CI accepted the FPEB findings, and was medically 
separated with a 10% disability rating. 

 

 

CI’s CONTENTION: The CI elaborated no specific contention on his application. 

 

 

SCOPE OF REVIEW: The Board’s scope of review as defined in DoDI 6040.44, 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 unfitting back condition (chronic thoracic and lumbar back pain) 
meet the criteria prescribed in DoDI 6040.44, and is accordingly addressed below. No other 
conditions are within the Board’s purview. Any condition outside the Board’s defined scope of 
review may be eligible for future consideration by the Army Board for Correction of Military 
Records. 

 

 

RATING COMPARISON: 

 

Army FPEB – dated 20020522 

VA (~1 mo. Post-Separation) – All Effective 20020705 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Thoracic & 
Lumbar Back Pain 

5299-5295 

10% 

Deformity of Thoracic Spine 

5299-5291 

10% 

20020830 

Lumbar Spine Disease 

5003 

10% 

20020830 

.No Additional MEB/PEB Entries. 

Not Service Connected x 1 

 

Combined: 10% 

Combined: 20% 



 

 

ANALYSIS SUMMARY: 

 

Chronic Back Pain. The CI reported that the onset of back pain was gradual, with no specific 
precipitating event such as trauma or injury. His pain was in the lower back (lumbar region) as 
well as the upper back (thoracic region). It started out episodically, and then became constant. 
He was seen by orthopedics, and it was decided that he was not a surgical candidate. In 
November 2001, a scoliosis survey showed mild S-shaped curvature of the thoracolumbar 
spine, with left convex curve measuring 10 degrees at mid-thorax, and right convex curve 
measuring 11 degrees at the thoracolumbar junction. Many different treatment options were 


tried for his back pain. In spite of treatment, his pain persisted and a MEB was initiated. The 
MEB clinical evaluation was in early 2002 at Fort Riley, Kansas. On physical examination, the CI 
had full range-of-motion (ROM). The final MEB narrative summary (NARSUM) was dictated on 
25 February 2002, and the diagnosis was scoliosis. As noted above, the CI was medically 
separated from the Army on 4 July 2002, due to chronic thoracic and lumbar back pain. 

 

Eight weeks later, he had a VA Compensation and Pension (C&P) exam. The examiner noted 
obvious deformity of the thoracic spine. There was discomfort to palpation over the mid-
thoracic region but not the lumbar region. ROM was measured and is shown in the chart 
below. Rotation was limited bilaterally but was not measured. Both left lateral movement and 
right lateral movement caused pain. Muscle strength was normal and there were no 
paresthesias. Sensation was normal. The goniometric ROM measurements from that C&P 
exam are shown in the chart below. 

 

Back ROM 

VA C&P ~8 weeks Post-Sep 

(20020830) 

Flexion 

90° 

Extension 

25° 

Right Lateral Flexion 

15° 

Left Lateral Flexion 

20° 

Right Rotation 

Not measured 

Left Rotation 

Not measured 

Comment 

Painful motion 



 

The Board carefully reviewed all of the evidentiary information available. The PEB combined 
the CI’s two chronic back pain problems into a single unfitting condition: “Chronic thoracic and 
lumbar back pain.” The condition was coded 5299-5295 and rated at 10%. The October 2002 
VA Rating Decision unbundled the two back pain conditions, and assigned a rating of 10% to 
each, resulting in a combined rating of 20%. The Board evaluated whether or not it was 
appropriate for the two chronic back pain problems to be “bundled” together. The Board must 
determine if the PEB’s approach of combining the conditions under a single rating was justified 
in lieu of separate ratings. The Board must apply separate codes and ratings in its 
recommendations if compensable ratings for each condition are achieved IAW the Veterans’ 
Administration Schedule for Rating Disabilities (VASRD). If the Board judges that two or more 
separate ratings are warranted, however, it must satisfy the requirement that each ‘unbundled’ 
condition was separately unfitting. After due deliberation, the Board agreed that the evidence 
supports a conclusion that each of the chronic back pain conditions, separately, would have 
rendered the CI unable to perform his required military duties. Accordingly, the Board 
recommends a separate disability rating for each of the two chronic back pain conditions. It is 
not appropriate for the thoracic pain and the lumbar pain to be “bundled” together, and 
treated as a single condition. 

 

The VASRD coding and rating standards for the spine, which were in effect at the time of the 
CI’s separation, were modified in September 2002, and then were changed again in September 
2003. The older standards were based on the rater’s opinion regarding degree of severity, 
whereas current standards specify certain rating thresholds, with measured degrees of ROM 
impairment. IAW DoDI 6040.44, the Board must use the VASRD coding and rating standards 
which were in effect at the time of the CI’s separation. Based on the evidence in the treatment 
record, the Board unanimously agreed that the CI’s thoracic back condition was best described 
as “moderate.” There was insufficient evidence in the treatment record to support classifying 
the thoracic back condition as “severe.” After due deliberation, considering all of the evidence 
and mindful of VASRD §4.3 (reasonable doubt), the Board unanimously recommends a rating of 
10% for the chronic thoracic back pain condition, IAW VASRD §4.59 and §4.71a. 

 


In like manner, the Board unanimously agreed that the CI’s lumbar back condition was best 
described as “slight.” There was insufficient evidence in the treatment record to support 
classifying the lumbar back condition as “moderate” or “severe.” After due deliberation, 
considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board 
unanimously recommends a rating of 10% for the chronic lumbar back pain condition, IAW 
VASRD §4.59 and §4.71a. 

 

 

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 chronic thoracic back pain condition, the Board 
unanimously recommends a rating of 10%, coded 5291, IAW §4.59 and §4.71a of the VASRD in 
effect at the time of separation. In the matter of the chronic lumbar back pain condition, the 
Board unanimously recommends a rating of 10%, coded 5292, IAW §4.59 and §4.71a of the 
VASRD in effect at the time of separation. There were no other conditions within the Board’s 
scope of review for consideration. 

 

 

RECOMMENDATION: The Board, therefore, 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 Thoracic Back Pain 

5291 

10% 

Chronic Lumbar Back Pain 

5292 

10% 

COMBINED 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120622, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxxxxx, AR20130007455 (PD201201287) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)