RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201569 SEPARATION DATE: 20030205 

BOARD DATE: 20130307 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SSGT/E-6 (92Y/Unit Supply Specialist), medically 
separated for chronic pain, due to cervical spondylosis and low back pain (LBP) due to lumbar 
degenerative joint disease (DJD) which did not improve adequately with treatment 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). One other condition, mild hearing loss, was also forwarded by the MEB. The Physical 
Evaluation Board (PEB) adjudicated the chronic pain, due to cervical spondylosis and LBP due to 
lumbar DJD conditions as unfitting, rated 10%, with application of the US Army Physical 
Disability Agency (USAPDA) pain policy. It determined that the mild hearing loss was not 
unfitting. The CI made no appeals and was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: The CI elaborated 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 chronic pain due to cervical spondylosis and LBP due to lumbar DJD will 
be reviewed. The MEB diagnosis of mild hearing loss was determined to be not unfitting by the 
PEB and was not contended by the CI; it is thus not within the 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 20021203 

VA (5 Mos. Pre -Separation) – All Effective Date 20030206 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Pain, Due to 
Cervical Spondylosis and 
LBP due to Lumbar DJD 

5099-5003 

10% 

DDD Cervical Spine 

5293-5290 

*30% 

20020925 

DDD Lumbar Spine 

5293-5292 

*40% 

20020925 

Mild Hearing Loss 

Not Unfitting 

NSC 

 

 

20020925 

.No Additional MEB/PEB Entries. 

DJD, Right Shoulder 

5203 

10% 

20020925 

Residuals of Right Knee Injury 

5260 

10% 

20020925 

Left Knee Strain 

5260 

10% 

20020925 

Tinnitus 

6260 

10% 

20020925 

0% X 1 / Not Service-Connected x 2 

20020925 

Combined: 10% 

Combined: *70% 



*Initially both were rated at 10% each. Per VARD dated 20040512 a clear and unmistakable error was made by the VA, the 
noted changes were made and the overall rating was changed to 70% effective 20030206 

 

 


ANALYSIS SUMMARY: The PEB combined chronic pain from cervical spine spondylosis and LBP 
due to lumbar DJD as the single unfitting and solely rated condition, coded analogously to 5099-
5003 and rated 10%. The PEB may have relied on AR 635.40 (B.24 f.) and/or the USAPDA pain 
policy for not applying separately compensable Veteran’s Affairs Schedule for Rating Disabilities 
(VASRD) codes. Not uncommonly this approach by the PEB reflects its judgment that the 
constellation of conditions was unfitting and that there was no need for separate fitness 
adjudications rather than a judgment that each condition was independently unfitting. If the 
Board judges that each ‘unbundled’ condition was unfitting in and of itself, the Board must 
apply separate codes and ratings in its recommendations if compensable ratings for each 
condition are achieved IAW VASRD §4.71a. Thus, the Board must exercise the prerogative of 
separate fitness recommendations in this circumstance, with the caveat that its 
recommendations may not produce a lower combined rating than that of the PEB. 

 

Cervical Spondylosis. The CI was first seen for neck pain in 1997 after a motor vehicle accident 
(MVA). In 1998, a bone scan performed to evaluate his LBP showed DJD of the cervical spine. 
He apparently did well until 2 years prior to separation when he noted the insidious onset of 
neck pain without recent trauma. On 3 December 2001, a magnetic resonance imaging (MRI), 
ordered to evaluate bilateral upper extremity (BUE) paresthesias was remarkable for moderate 
degenerative disc disease (DDD) at C6-7 with a disc protrusion and right foraminal stenosis. He 
was seen in neurosurgery on 26 March 2002. The CI reported an 18-month history of pain 
which radiated into both arms and was associated with paresthesias. Conservative 
management had not been successful and high impact activities aggravated his pain. The 
neurosurgeon documented that electrodiagnostic studies of BUE had been normal, indicative of 
no neurological impairment. This report is not in evidence. On examination, the CI had 
minimal tenderness over the neck. He had normal sensation, strength, reflexes, and full range-
of-motion (ROM). There was no mention of spasm of neck muscles. He had a normal gait. 
Compression of the turned neck, a provocative test for cervical radiculopathy, did not 
reproduce the symptoms. The neurosurgeon did not recommend surgery. The CI's 
commander's statement dated 31 July 2002 cites his profile as basis for stating that the CI is 
non-deployable; this statement does not mention any specific underlying diagnosis. The CI was 
given several profiles for his neck. The final profile was a permanent U3L3H2 profile on 16 
August 2002. At the MEB examination on 28 August 2002 (6 months prior to separation), the 
narrative summary (NARSUM) documented slight tightness of the neck muscles bilaterally and 
full ROM was demonstrated. Sensation and strength of upper extremities were normal as was 
the gait. There was no muscle atrophy. There was no specific comment regarding spasm. At 
the VA Compensation and Pension (C&P) on 25 September 2002 (5 months prior to separation), 
the CI complained of neck pain going to his shoulders and that the neck pain is constant. He 
also stated the neck pain does not require bed rest or the attention of a physician. His ROM 
was reduced and painful in all planes and the CI declined to rotate his head either to the left or 
right secondary to pain. There was no reason provided in the record to explain the significant 
decrease in the ROM in a month. There were no neurological abnormalities, muscle spasm, or 
radiculopathy. The Board first considered if DDD cervical spine, having been de-coupled from 
the combined PEB adjudication, remained independently unfitting as established above. The 
Board notes that an MRI revealed moderate DDD. The CI had neck pain for several years with 
no apparent improvement anticipated. The CI was placed on multiple profiles that specifically 
noted his cervical disease (along with lumbar disc disease) as one of the conditions for 
permanent duty restrictions. The commander did not distinguish between the neck and the 
back in his statement that the CI cannot perform his duties within the limits of his profile. After 
consideration of above, all members agreed that DDD cervical spine, as an isolated condition, 
would have rendered the CI incapable of continued service within his MOS; and, accordingly 
merited a separate rating. 

 

The Board directed 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 noted that the 2003 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 discussed the CI's ROM at the neurosurgical examination (10 
months prior to separation), the MEB examination (6 months prior to separation), and the C&P 
exam (5 months prior to separation). In assigning probative value to these somewhat 
conflicting examinations, the Board notes that two separate prior to separation examinations, 
the neurosurgical consult and the MEB examination, documented normal ROM of the cervical 
spine. There is not a reasonable explanation for the significantly more limited ROM in the one 
month interval between the MEB and VA examinations. Therefore, based on all evidence and 
associated conclusions just elaborated, the Board is assigning preponderant probative value to 
the MEB evaluation. The Board considered the various rating options for the neck and noted 
that DDD was clearly present on the MRI. The neurological examination and the ROM on the 
two probative examinations were normal. There was neither incapacitation documented nor 
was there muscle atrophy. The CI did have minimal tenderness at the prior to separation 
neurological consultation and had slight tightness of the neck muscles at the MEB examination 
in addition to the positive MRI findings. The Board determined that these findings supported a 
10% rating for the neck utilizing an analogous code 5099-5003, degenerative arthritis. The 
Board could find no route to a higher rating. Thus after due deliberation, considering all of the 
evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability 
rating of 10% coded 5099-5003 for the DDD cervical spine condition. 

 

Degenerative Disc Disease Lumbar Spine. The CI first was seen for LBP after falling off a vehicle 
almost 10 years prior to separation. He was treated with medications and physical therapy 
with resolution over the next year. In 1997, the CI was in a MVA with recurrent pain. X-rays 
showed mild DJD at L4. He was treated with medications, physical therapy, and chiropractic 
care, but had continued pain. A CT scan of the lumbar spine on 28 May 1998 revealed a mild 
disc bulge at L5-S1, without significant canal or neuroforaminal narrowing, and degenerative 
changes at L4-L5 and L5-S1. He was seen by Physical Medicine and Rehabilitation (PMR) on 
12 June 1998 and continued conservative management recommended. An orthopedic 
evaluation on 23 September 1998 recommended no surgery. A bone scan, accomplished on 
18 November 1998 for the LBP, showed increased uptake in the cervical spine, right 
acromioclavicular (AC) joint, and sternomanubrial joint; however, the thoracolumbar spine was 
normal. He continued conservative management with periodic follow up in orthopedics and 
family practice over the next few years. He was given a permanent U3L3 profile and referred to 
MEB. A neurosurgical consult to the MEB on 26 March 2002 (10 months prior to separation) 
noted normal gait, normal ROM of the lumbar spine, and normal sensation, strength, and 
reflexes. Heel and toe walk were normal. The CI reported minimal sciatic pain and no 
incontinence. He did have minimal tenderness to palpation and there was no comment 
regarding spasm. The CI's commander's statement dated 31 July 2002 cites his profile as the 
basis for stating that the CI is non-deployable; this statement does not mention any specific 
underlying diagnosis. The CI had multiple temporary profiles for his back. The final, permanent 
U3L3H2 profile was issued on 16 August 2002 citing his back, neck, and hearing conditions. The 
MEB narrative summary (NARSUM) dated 28 August 2002 (6 months prior to separation) noted 
the CI had full ROM of lumbar spine and normal gait, reflexes, sensation, and strength; there 
was no comment regarding spasm. No incapacitation was noted. At the C&P exam on 
25 September 2002 (5 months prior to separation), the CI stated he had constant pain and 
required bed rest for several hours and the attention of a physician two to three times a month. 
This is not supported by the records in evidence. Posture and gait were normal. His ROM was 
reduced to 30 degrees in flexion as well as 20 degrees in extension. There was also loss in all 
other planes of movement. The ROM was limited by pain. There were no neurological 
abnormalities, muscle spasm, tenderness, or radiculopathy. X-rays showed minimal 
spondylosis (degenerative changes). The Board first considered if DDD lumbar spine, having 
been de-coupled from the combined PEB adjudication, remained independently unfitting as 
established above. The Board notes that the CI had organic basis for his pain in that a CT 


revealed disc bulge and degenerative disc disease. The CI was placed on numerous profiles that 
specifically noted his lumbar disease as a condition for permanent duty restrictions. The 
commander did not distinguish between the neck and the back; a letter from the CI's 
commander dated 31 July 2002 stated that the CI cannot perform his duties within the limits of 
his profile. After consideration of above, all members agreed that DDD lumbar spine, as an 
isolated condition, would have rendered the CI incapable of continued service within his MOS; 
and, accordingly merited a separate rating. 

 

The Board directed its attention to the 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 that the 2003 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. As already discussed for the cervical spine, the MEB examination is given 
the highest probative value for rating purposes. The Board considered the various rating 
options for the back. The MEB examiner documented a normal gait, neurological examination, 
and ROM. Neither spasm nor incapacitation was noted. The most proximate X-ray to 
separation showed minimal spondylosis. The Board determined that the presence of the X-ray 
findings in the absence of limitation in ROM and incapacitation supported a 10% for the back 
via analogous code 5099-5003, degenerative arthritis. The Board could find no route to a 
higher rating. Thus after due deliberation, considering all of the evidence and mindful of 
VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% coded 5099-
5003 for the DDD lumbar spine 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. As discussed above, PEB 
reliance on the USAPDA pain policy for rating chronic pain due to cervical spondylosis and LBP 
due to lumbar DJD was operant in this case and the conditions were adjudicated independently 
of that policy by the Board. In the matter of the DDD cervical spine condition, the Board 
unanimously recommends a disability rating of 10%, coded 5099-5003 IAW VASRD §4.71a. In 
the matter of the DDD lumbar spine condition, the Board unanimously recommends a disability 
rating of 10%, coded 5099-5003 IAW VASRD §4.71a. 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 

Degenerative Disc Disease Cervical Spine 

5099-5003 

10% 

Degenerative Disc Disease Lumbar Spine 

5099-5003 

10% 

COMBINED 

20% 



 

 

 

 

 

 

 

 

 

 


The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120913, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxx, AR20130007485 (PD201201569) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)