RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX CASE: PD1201541 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130327 

SEPARATION DATE: 20011029 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (73D/Accounting Specialist) medically 
separated for chronic low back pain (LBP). The CI had gradual onset of back pain over the past 
2 years and states that he recalls no specific injury. After a series of physical therapy, 
osteopathic manipulation, and anti-inflammatory drugs and muscle relaxants, the CI’s 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 
P3L3 profile and referred for a Medical Evaluation Board (MEB). The chronic LBP condition, 
characterized as “mechanical low back pain” was forwarded to the Physical Evaluation Board 
(PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The PEB adjudicated 
the chronic LBP as unfitting, rated 10%, with likely application of the US Army Physical Disability 
Agency (USAPDA) pain policy. The CI did not concur with the PEB’s decision and submitted 
evidence for reconsideration. An Informal Reconsideration PEB upheld the initial decision and 
the CI was separated with that disability rating. 

 

 

CI CONTENTION: “Rating should be changed because member is suffering from chronic back 
pain. Member is taken daily medication and is unable to perform daily, normal activities. Visits 
to chiropractor have not helped nor has periodic shots to ease the pain. Over the years the 
pain has become extremely worse with constant pain in the buttock as well as sharp pains 
shooting the down the legs. The inability to exercise due to the chronic back pain has also led 
to obesity, which has caused repeated incidents of gout and member also suffers from high 
blood pressure. Although he has yet to be diagnosed for it, member has shown forms of 
depression. Recently he has doctors, both civilian and military, and is currently being seen at 
the VA clinic in Dothan, AL.” (sic) 

 

 

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 chronic LBP condition 
is addressed below; and, no additional conditions are 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 
respective Board for Correction of Military Records. 

 

RATING COMPARISON: 

 

Service Recon IPEB – Dated 20010709 

VA - (~6 Mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Low Back Pain 

5299-5295 

10% 

Spondylosis of the Lumbosacral 
Spine 

5295 

10% 

20020226 

No Additional MEB/PEB Entries 

Other x N/A 

Combined: 10% 

Combined: 10% 



 

 


ANALYSIS SUMMARY: 

 

Chronic Low Back Pain Condition: The MEB narrative summary (NARSUM), dated 03 May 2001, 
5 months prior to separation notes the CI reported gradual onset of back pain over the 2 years 
prior to the exam. He said he recalled no specific injury and described symptoms as consisting 
of spasm and pain, mostly in the lower back. He had been treated with physical therapy with 
some improvement of symptoms. He also stated he underwent osteopathic manipulation with 
temporary improvement, but without resolution of pain. In addition, he had been treated with 
NSAID's and muscle relaxants. At the MEB physical exam, it was noted that there was 
tenderness to palpation of the paraspinal muscles of the lumbosacral region. Forward flexion 
was described as being to the level where the fingertips reached to the tops of the patellae. 
Extension was 15 degrees; right flexion was 20 degrees and left flexion was 30 degrees. 
Straight leg raising test was negative. Patellar and Achilles reflexes were normal, as was 
strength in the lower limbs bilaterally. Gait, toe walking and heel walking were normal. “The CI 
did experience pain with squatting walk, but was able to perform it without obvious gait 
disturbance.” Neurological exam was reported to be normal. Lateral spine X-ray performed on 
2 Oct 2000, showed sacralization of the left transverse process of L5, straightening of the 
normal lordosis and early degenerative disk disease at L4/L5. Magnetic resonance imaging 
(MRI) on 4 June 2001 was reported as a normal study with no evidence of disk bulge or 
herniation. The DD Form 2808 MEB exam dated 25 Apr 2001, (shortly before the NARSUM) 
indicated tenderness, forward bending to mid-thigh secondary to pain and limited extension 
secondary to pain. There were rare medical entries noting spasm, and most entries indicated 
near normal or normal range-of-motion (ROM) evaluations with pain. 

 

At the VA Compensation and Pension (C&P) exam performed on 26 February 2002, 
approximately 4 months after separation, the CI continued to report lower back pain. He 
stated his pain was constant, describing the severity as a 5-6 on a scale of 1-10. He said he had 
been treating his symptoms with Percocet and muscle relaxants which caused drowsiness, so 
most recently, he had been taking only aspirin to avoid the drowsiness caused by his other 
medications. The C&P examination revealed paraspinal tenderness in the lumbosacral spine 
area. There was mild spasm of the muscles in the same area. Straight leg raise test was 
negative. ROM evaluations recorded were: forward flexion to 70 degrees, backward extension 
to 5 degrees, right and left lateral flexion “normal.” The CI reported pain when attempting 
rotation. Posture, gait and reflexes were reported to be normal. 

 

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 the 2001 VASRD standards for the spine were 
in effect at the time of separation. The Board must correlate the above clinical data with the 
2001 rating schedule (applicable diagnostic codes include: 5292 [limitation of lumbar spine 
motion]; 5293 [intervertebral disc syndrome]; and 5295 [lumbosacral strain]). The PEB rated 
10% coded analogously as 5299-5295. Citing characteristic pain on motion, the VA rated the 
condition at 10% coded 5295. Based on the documented ROMs, the Board agreed the CI's 
lumbar limitation of motion was best characterized as "slight" and his back condition would 
rate no higher than 10% under code 5292. With no documentation of muscle spasm on 
extreme forward bending or loss of lateral spine motion, the Board agreed the condition would 
be rated 10% under code 5295 for characteristic pain on motion. The Board discussed 
symptoms of intervertebral disc syndrome using the 2001 VASRD criteria, and if the CI’s 
disability picture was better characterized as “mild” (10%) or “moderate; recurring attacks” 
given the level of symptoms and medication use. Though the CI had ongoing treatment for 
pain, the service treatment records did not document recurring attacks, and there was no 
objective evidence of an intervertebral disc syndrome. The Board thus concluded that 
alternatively rating his back condition under code 5293 (intervertebral disc syndrome) did not 
rise to the higher “moderate; recurring attacks” 20% criteria and the disability was closer to the 


“mild” 10% rating level. Alternative coding using 5293 at 10% was not predominate to the PEB 
10% rating under code 5295. After due deliberation, considering all of the evidence and 
mindful of VASRD §4.3 (Resolution of reasonable doubt), the Board unanimously concluded 
there was insufficient cause to recommend a change in the PEB adjudication of 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. The Board was unclear if 
the PEB ruling in this case relied on the USAPDA pain policy or the VASRD for rating the low 
back condition and the condition was adjudicated independently of the USAPDA pain policy by 
the Board. In the matter of the chronic LBP condition and IAW 2001 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 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 20120621, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxx, 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 
xxxxxxxxxxxxxxxxxxxxxxxx, AR20130008742 (PD201201541) 

 

 

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 xxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)