RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD121648 SEPARATION DATE: 20020607 

BOARD DATE: 20130308 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (52C/Utility Equipment), medically separated 
for a degenerative disk disease (DDD) of the thoracic spine. Treatment and therapy was 
attempted after initial onset of conditions in 1997, but the CI could not be adequately 
rehabilitated to meet the requirements of his Military Occupational Specialty (MOS) or physical 
fitness standards. He was consequently issued a permanent L3 profile and referred for a 
Medical Evaluation Board (MEB). The MEB made six diagnoses and sent the case to the Physical 
Evaluation Board (PEB). The PEB adjudicated “Degenerative disc disease…T7-8…” as unfitting 
and rated 10%. The CI made no appeals and was medically separated with a 10% disability 
rating. 

 

 

CI CONTENTION: The application states “Depression, degenerative disk disease, total rating 
100%.” The application does not elaborate or specify a request for Board consideration of any 
additional conditions. 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in 
Department of Defense Instruction (DoDI) 6040.44 (Enclosure 3, paragraph 5.e.2) is limited to 
those conditions 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 listed not unfitting conditions, as requested for consideration, meet 
the criteria prescribed in DoDI 6040.44 for Board purview and are addressed below, in addition 
to a review of the ratings for the unfitting DDD. The requested condition of depression was not 
identified by the PEB and is therefore 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 PEB – Dated 20020416 

VA (2 Mo. Pre-Separation) – Effective 20020608 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Degenerative Disc Disease T7-8, 
with Herniation w/ Radicular Type 
Pain…alternately Dx’d as 
Costochondritis 

5299-5293 

10% 

Degenerative Disc Disease with 
Diffuse Disc Bulge 

5293 

20% 

20020408 

Patellofemoral Arthrosis, Right 
Knee 

Not Unfitting 

Right Knee Patellofemoral 
Arthrosis 

5260 

10% 

20020408 

Chronic Ankle Instability, Right 

Not Unfitting 

Right Ankle Peroneal Tendinitis 

5271 

10% 

20020408 

Grade I AC Separation, Right 

Not Unfitting 

Residuals, Right AC Separation 

5203 

10% 

20020408 




.No Additional MEB/PEB Entries. 

Adjustment Disorder with 
Depression and Anger 

9440 

30% 

20040418 

0% X 3 / Not Service Connected x 3 

20020408 

Combined: 10% 

Combined: 60% 



 

ANALYSIS SUMMARY: 

 

Degenerative Disc Disease (DDD) Condition. The narrative summary (NARSUM) dictated 3 
months prior to separation notes a history of mid back pain since 1997. There was no history of 
trauma. The CI reported mid back pain radiating to the ribs and right flank. The pain was 
described as a constant ache with numbness and tingling in the right flank. The pain was rated 
at 5-6/10, but increased to 10/10 with strenuous activity. A magnetic resonance imaging (MRI) 
study in March 2001 revealed mild DDD at T7-8 with mild diffuse disc bulge without evidence of 
spinal stenosis or herniated disc. Physical medicine and neurosurgical consultants determined 
that the CI’s pain level did not reach the threshold for surgical intervention. The CI was treated 
with pain medications, anesthetic injections, and physical therapy with transient relief of his 
mid-back pain with T7 radiculopathy pain. The NARSUM examination demonstrated 
hypersensitivity along the T6-T8 distribution, pain to palpation of the right paraspinal muscles, 
and decreased sensation of the T6-T8 area on the right. The 7th and 8th ribs were tender to 
palpation at the costal margins. At the VA Compensation and Pension (C&P) exam 2 months 
prior to separation the CI reported pain with bending. The pain was described as worse at night 
and disturbed his sleep. The physical examination was significant for tenderness from the third 
rib to the end of his rib cage on the right. His back was not tender to palpation and his ROM 
was normal. There were no gait abnormalities noted. The goniometric range-of-motion (ROM) 
evaluations in evidence which the Board weighed in arriving at its rating recommendation, with 
documentation of additional ratable criteria, are summarized in the chart below. 

 

Thoracolumbar ROM 

 (In degrees) 

PhysMed ~6 Mo. Pre-Sep 

NARSUM ~3 Mo. Pre-Sep 

VA C&P ~2 Mo. Pre-Sep 

Flexion (90 Normal) 

? 

80 

90 

Ext (0-30) 

10 

10 

# 

R Lat Flex (0-30) 

20 

- 

WNL 

L Lat Flex 0-30) 

20 

- 

WNL 

R Rotation (0-30) 

20 

15 

WNL 

L Rotation (0-30) 

20 

15 

WNL 

Comment 

Forward flexion 
fingertips to patella Pain 
limitation of motion 

Hypersensitivity to pain 
right greater than left 

Back is nontender, gait is 
normal 

§4.71a Rating 

10% 

10% 

0% (VA-20%) 



 

The Board directs attention to its rating recommendation based on the above evidence. Both 
the VA and the PEB applied the 5293 code (intervertebral disc syndrome) for thoracic DDD. The 
PEB determined the condition was “mild”, thus warranting a 10% rating, while the VA deemed 
the condition “moderate with recurring attacks” in support of a 20% rating. The Board 
considered that multiple notes in the service treatment record (STR) documented treatment for 
mid-back and rib pain, with right rib cage pain hypersensitivity, numbness, and tingling. The 
neurosurgical and physical medicine consultants considered the CI’s symptom severity level as 
moderate, but not reaching the threshold for surgical intervention. However, the VA 
examination most proximate to separation documented no objective pain findings of the back, 
a normal gait and normal ROM. Considering the totality of the evidence and mindful of VASRD 
§4.3 (reasonable doubt), Board consensus was that a disability rating of 10% most accurately 
depicted the clinical condition under the 5293 code in this case. Board members agreed that a 


higher rating was not possible under the other applicable code (5291; spine, limitation of 
motion, dorsal). After due deliberation, considering all of 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 degenerative disc disease condition. 

 

Contended PEB Conditions. The contended conditions adjudicated as not unfitting by the PEB 
were right knee patellofemoral arthrosis, chronic right ankle instability and Grade 1 right 
acromioclavicular separation. The Board’s first charge with respect to these conditions is an 
assessment of the appropriateness of the PEB’s fitness adjudications. 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. None of these conditions were permanently profiled; none were 
implicated in the commander’s statement; and, none were judged to fail retention standards. 
All were reviewed by the action officer and considered by the Board. There was no indication 
from the record that any of these conditions significantly interfered with satisfactory duty 
performance. 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 any of the contended conditions; and, therefore, no additional 
disability ratings can be 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 DDD condition and IAW VASRD §4.71a, the Board 
by a vote of 2:1 recommends no change in the PEB adjudication. The single voter for dissent 
(who recommended a 20% rating) did not elect to submit a minority opinion. In the matter of 
the contended right patellofemoral arthrosis, chronic right ankle instability, and Grade 1 right 
acromioclavicular separation conditions, the Board unanimously 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, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Thoracic Degenerative Disc Disease 

5299-5293 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120918, 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 / xxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxxxxxxx, AR20130006852 (PD201201648) 

 

 

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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)