RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201318 SEPARATION DATE: 20011006 

BOARD DATE: 20130305 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (92Y/Supply Specialist), medically separated 
for chronic low back pain (LBP). Low back symptoms followed a motor vehicle crash in January 
2000, and following conservative treatment, did not improve adequately 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 
MEB forwarded no other conditions for Physical Evaluation Board (PEB) adjudication. The PEB 
adjudicated the chronic LBP condition as unfitting, rated 10%, with application of the 
Department of Defense Instruction (DoDI) 1332.39 and the US Army Physical Disability Agency 
(USAPDA) pain policy. The CI made no appeals, and was medically separated with a 10% 
disability rating. 

 

 

CI CONTENTION: “Disc problems, migraines and other health issues preventing me to fulfill the 
requirements of a 92Y.” 

 

 

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 back pain condition requested 
for consideration meets the criteria prescribed in DoDI 6040.44 for Board purview, and is 
accordingly addressed below. The other requested conditions [migraines and other health 
issues] are not within the Board’s purview. Any condition 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 20010814 

VA (~3 Mos. Post-Separation) – All Effective Date 20011007 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic LBP 

5299-5295 

10% 

Low Back Condition 

5293 

20%* 

20020130 

No Additional MEB/PEB Entries 

Residual, Migraine Headaches 

8100 

30% 

20020130 

Residuals, Left Knee Disability 

5010-5261 

10% 

20020130 

0% X 1 / Not Service-Connected x 4 

20020130 

Combined: 10% 

Combined: 50% 



*Reduced to 10% effective 20050401, VARD 20050111; missed C&P exam 

 

 

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 
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. 

 

Chronic Low Back Pain Condition. Symptoms of LBP first began secondary to a bus rollover 
accident when the CI was enroute from Advanced Individual Training (AIT) to her first duty 
station on 22 January 2000. She was evaluated at a civilian emergency department and 
released. She was seen the next day and diagnosed with multiple sprains and strains. 
Symptoms of lumbar pain persisted, and magnetic resonance imaging (MRI) performed 
23 February 2000 was normal without evidence of disc herniation or disc protrusion. Service 
medical records document continued care by orthopedics, but symptoms failed to resolve with 
treatment. At an orthopedic evaluation on 24 January 2001, flexion was documented as 
reaching finger tips to within four inches of the floor, extension 30 degrees, and side bending of 
20 degrees to both sides. Strength, sensation and reflexes were normal. The orthopedic 
surgeon diagnosed mechanical LBP. At the time of the MEB narrative summary (NARSUM) on 
23 July 2001, the CI reported persistent LBP. The CI reported that she was not taking any 
medications for the pain, since no medication had helped. The MEB physical exam noted that 
the spine was “within normal limits,” with “mild tenderness at the left paraspinal lumbar 
musculature.” The neurological examination was with normal limits. The VA Compensation 
and Pension (C&P) examination performed 30 January 2002, 4 months after separation, noted 
that the CI continues to complain of LBP, which she states “happens every day.” She reported 
“pain down the back of her right thigh into her knee, however, she does not have pain 
extending down her feet or any numbness or paresthesias in her feet.” She denied any bowel 
or bladder incontinence. On examination, lumbosacral spine range-of-motion (ROM) was 60 
degrees, extension 20 degrees, rotation 90 degrees. Strength and reflexes were normal and 
straight leg raise (SLR) test was negative. The examiner noted that the CI “probably has 
mechanical low back pain without any evidence of radiculopathy.” A CT scan, 28 February 
2002, 5 months after separation, demonstrated bulging discs at L3-4 and L4-5 without 
impingement upon nerve structures. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated 10% for characteristic pain on motion using the code for lumbosacral strain 5295. 
The VA rated the condition 20% for recurring attacks of moderate intervertebral disc syndrome 
(5293). 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 Veteran 
Administration Schedule for Rating Disabilities (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 2002 rating schedule, in which the 
applicable diagnostic codes include 5292 (limitation of lumbar spine motion), 5293 
(intervertebral disc syndrome), and 5295 (lumbosacral strain). The Board first considered the 
rating under the VASRD diagnostic code 5292 in effect at the time. The MEB NARSUM did not 
document a ROM examination; however, the orthopedic examination in January 2001 
documented slight limitation of motion with the ability to reach the finger tips to within 4 
inches of the floor. The Board noted the post separation C&P examination reported 
“lumbosacral spine” ROM, and further noted that this examination occurred prior to the 
current VASRD guidelines that utilize combined thoracolumbar ROM. The Board therefore 
concluded the C&P examiner was reporting lumbosacral ROM without the inclusion of thoracic 
motion. Normal lumbar flexion is 60 degrees. The reported 60 degrees of lumbosacral flexion 


is normal and would be consistent with the ability to reach the fingertips to within four inches 
to the floor, as documented by the prior orthopedic examination, and is consistent with the 
normal MRI. The Board concluded the preponderance of evidence supported no higher than a 
10% rating under 5292, limitation of lumbar spine motion. The Board next considered whether 
a higher rating was warranted under the guidelines for intervertebral disc syndrome, code 
5293, which was used by the VA in January, 2002. MRI in February 2000 demonstrated no 
evidence of intervertebral disc disease. Although the CI did report radiating pain, all 
examinations were negative for signs of radiculopathy or objective neurologic findings. The 
Board noted the CT scan following separation demonstrating bulging discs without 
impingement on neural structures. The Board concluded that the CI’s back pain was more 
consistent with the mechanical LBP diagnosed by orthopedic surgery. Regardless, the Board 
also concluded the back pain condition did not approach the 20% rating under the 5293 code. 
The Board then considered the rating under the code, 5295, lumbosacral strain, utilized by the 
PEB, and noting that the diagnosis of lumbosacral strain had been documented on 9 January 
2001. The Board discussed if the evidence would support a higher rating under this code. 
There was no documentation of muscle spasm on extreme forward bending, and no loss of 
lateral spine motion to support the 20% rating. The Board concluded that the preponderance 
of evidence did not support a rating higher than the 10% rating assigned by the PEB. After due 
deliberation, considering all 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 low back pain condition (code 5299-5295). 

 

 

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. As discussed above, PEB 
reliance on DoDI 1332.39 and the USAPDA pain policy for rating chronic LBP was operant in this 
case and the condition was adjudicated independently of that instruction by the Board. 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 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120626, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

xxxxxxxxxxxxxxxxxxxxxxx, 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 
xxxxxxxxxxxxxxxxxxxxxxx, AR20130007524 (PD201201318) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)