RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  MARINE CORPS 
SEPARATION DATE:  20081128 

 
NAME:    
CASE NUMBER:  PD1200095 
BOARD DATE:  20121005 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty Sgt/E-5 (6672/Aviation Supply Specialist), medically 
separated for fibromyalgia causing chronic neck and back pain.  The CI had a long history of 
chronic pain that was ultimately diagnosed as fibromyalgia and was unresponsive to multiple 
therapeutic modalities.  The CI was unable to meet the physical requirements of her Military 
Occupational Specialty (MOS or satisfy physical fitness standards.  She was placed on limited 
duty  (LIMDU)  and  referred  for  a  Medical  Evaluation  Board  (MEB).    Headache  and  bilateral 
carpal  tunnel  syndrome,  identified  in  the  rating  chart  below,  were  also  identified  and 
forwarded  by  the  MEB.    The  condition  of  fibromyalgia  had  been  considered  by  an  Informal 
Physical Evaluation Board (IPEB) in January 2004 and the CI had been found fit for duty.  A MEB 
was performed in August 2007 but apparently did not get forwarded to a PEB. The most recent 
MEB  was  performed  in  June  2008.    An  IPEB  performed  on  10  July  2008  adjudicated  the 
fibromyalgia  causing  chronic  neck  and  back  pain  condition  as  unfitting,  rated  20%,  with 
application SECNAVINST 1850.4E.  The remaining conditions were determined to be Category II 
(headache),  and  Category  III  (carpal  tunnel  syndrome  bilaterally).    The  CI  requested  a 
reconsideration  of  these  findings  later  that  month  and  submitted  documents  pertaining  to 
other  medical  conditions.  She  also  notified  the  PEB  she  would  request  a  Formal  PEB  if  the 
findings  were  not  changed.  A  Reconsideration  PEB  convened  on  20  August  2008  and  no 
changes were made.  The CI accepted the reconsidered findings and was medically separated 
with a 20% disability rating.   
 
 
CI CONTENTION:  “Not all medical issues were mentioned and given compensation in medical 
separation. I was separated on Fibromyalsia [sic] and Headaches only despite having a Pinched 
Nerve, Bilateral Carpal Tunnel, (2) Herniated Discs in the low back L4 & L5/S1 as well as the C3 
& C2 in the neck. I also suffered from Depression and PTSD from constant sexual harassment 
(MST) as well as defamation of character.” 
 
 
SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in the 
Department of Defense Instruction (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 headache, pinched nerve and herniated discs in the back and neck, and carpal 
tunnel  syndrome  bilaterally  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  condition  of  fibromyalgia.    The  other  requested  conditions 
(depression  and  post  traumatic  stress  disorder)  are  not  within  the  Board’s  purview.  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 Board for Correction of 
Naval Records.   
 
 
 

RATING COMPARISON:   
 

Service FPEB – Dated 20080820 
Condition 

Code 

Rating 

Fibromyalgia Causing 
Chronic Neck and Back 
Pain 
Headache 

Carpal Tunnel 
Syndrome Bilaterally 

5025 

20% 

CAT II 

CAT III 

↓No Additional MEB/PEB Entries↓ 

Combined:  20% 

VA (~2 Months Post-Separation) – All Effective Date 20081130 

Condition 

Strain, Cervical Spine 
Strain, Lumbar Spine 
Fibromyalgia with Headaches 
Carpal Tunnel Syndrome, also Claimed as 
Median Neuropathy, Left (Non-Dominant) 
Carpal Tunnel Syndrome, also Claimed as 
Median Neuropathy, Right (Dominant) 
Undifferentiated Somatoform Disorder 

Code 
5237 
5237 
5025 
8599-
8515 
8599-
8515 
9421 

Rating 
10% 
10% 
40% 

0%* 

0%* 
10% 

Exam 

20090204 
20090204 
20090204 
20090204 
20090204 
20090131 

0% X 1 other / Not Service-Connected x 10 

Combined:  60% 

*Both increased to 10% and combined rating increased to 70% effective 20100824. 
 
 
ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding  the  significant  impairment  with  which  her  service-incurred  condition  continues  to 
burden  her.    The  Board  acknowledges  the  CI’s  contention  that  suggests  ratings  should  have 
been conferred for other conditions documented at the time of separation.  The Board wishes 
to clarify that it is subject to the same laws for service disability entitlements as those under 
which  the  Disability  Evaluation  System  (DES)  operates.    While  the  DES  considers  all  of  the 
service  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.    However  the  Department  of  Veteran  Affairs  (DVA),  operating 
under a different set of laws (Title 38, United States Code), is empowered to compensate all 
service-connected conditions and to periodically reevaluate said conditions for the purpose of 
adjusting the Veteran’s disability rating should his degree of impairment vary over time.  The 
Board  utilizes  DVA  evidence  proximal  to  separation  in  arriving  at  its  recommendations;  and, 
DoDI  6040.44  defines  a  12-month  interval  for  special  consideration  to  post-separation 
evidence.  The Board’s authority as defined in DoDI 6040.44, however, resides in evaluating the 
fairness  of  DES  fitness  determinations  and  rating  decisions  for  disability  at  the  time  of 
separation  and  is  limited  to  conditions  adjudicated  by  the  PEB  as  either  unfitting  or  not 
unfitting.  Post-separation evidence therefore is probative only to the extent that it reasonably 
reflects the disability and fitness implications at the time of separation. 
 
Fibromyalgia  Causing  Chronic  Neck  and  Back  Pain  Condition.    The  MEB  narrative  summary 
(NARSUM) performed on 5 June 2008 describes an extended timeline of chronic pain attributed 
to multiple different diagnoses, including psychiatric disorders, with the ultimate diagnosis of 
fibromyalgia.    All  of  the  patient’s  complaints  except  those  related  to  bilateral  carpal  tunnel 
syndrome  can  be  attributed  to  fibromyalgia.    Fibromyalgia  was  independently  diagnosed  by 
three separate rheumatologists, one civilian performed in January 2007, one Navy performed in 
April 2007, and one Army performed in January 2008.  The latest psychiatric evaluation prior to 
separation from service was performed in March 2008.  It documents no evidence of a mental 
health condition or personality disorder.  The CI understandably experienced some symptoms 
of  depression  and  anxiety  throughout  her  diagnostic  course  of  events,  but  was  free  of  any 
psychiatric symptoms and diagnoses at the time of separation, at which time her GAF was 85.  
 
The CI did however have significant symptoms of chronic pain, headaches, and gastrointestinal 
irritability due to fibromyalgia at the time of separation.  The MEB NARSUM did not comment 
on frequency of symptoms or response to therapy.  However, multiple outpatient notes from 
2008  document  constant  pain  that  was  not  relieved  with  medication  and  minimally  relieved 
with physical therapy.  A VA Compensation and Pension (C&P) spine examination performed in 
February  2009  also  documents  no  relief  from  pain  medication.    A  general  C&P  examination 

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performed in February 2009 documented minimal results with Lyrica or any other medications.  
At the time of that examination she had pain and exhaustion everyday and one a day a week 
she  was  unable  to  do  anything  at  all.    However,  her  gastrointestinal  symptoms  at  that  time 
were limited to occasional constipation.  
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
initial and reconsideration PEBs applied a 20% rating for fibromyalgia.  The VA applied a 40% 
rating based on widespread musculoskeletal pain and tender points, with or without associated 
symptoms that are constant, or nearly so, and refractory to therapy.  The evidence available 
supports  a  finding  of  constant  pain  with  associated  fatigue,  sleep  disturbance,  stiffness, 
paresthesias,  and  headaches.    Her  pain  and  exhaustion  were  constant  with  intermittent 
periods of worsening.  After due deliberation, considering all of the evidence and mindful of 
VASRD  §4.3  (reasonable  doubt),  the  Board  recommends  a  disability  rating  of  40%  for  the 
fibromyalgia condition.   
 
Contended  PEB  Conditions.    The  contended  conditions  adjudicated  as  not  unfitting  or  not 
separately unfitting by the PEB were headache, pinched nerve, herniated discs in the back and 
neck,  and  carpal  tunnel syndrome  bilaterally.   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 implicated in the 
commander’s  non-medical  assessment  and  none  were  judged  to  fail  retention  standards  as 
separate  conditions.    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 separately from the fibromyalgia condition.  The headaches 
as well as back pain and neck pain with pinched nerve and herniated discs in the back and neck 
are  all  part  of  the  unfitting  fibromyalgia  condition.    There  is  no  evidence  in  the  record  of  a 
headache, back, or neck condition separate from the fibromyalgia condition.  Bilateral carpal 
tunnel is not considered as part of fibromyalgia but there is no evidence it was unfitting at the 
time  of  separation.    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  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.    In  the  matter  of  the 
fibromyalgia condition, the Board unanimously recommends a disability rating of 40%, coded 
5025 IAW VASRD §4.71a.  In the matter of the contended headache, pinched nerve, herniated 
discs  in  the  back  and  neck,  and  bilateral  carpal  tunnel  syndrome  conditions,  the  Board 
unanimously recommends no change from the PEB determination they were not unfitting or 
separately unfitting.  There were no other conditions within the Board’s scope of review.   
 
 
RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as 
follows,  that  the  discharge  with  severance  pay  be  recharacterized  to  reflect  permanent 
disability retirement, effective as of the date of her prior medical separation:   
 
 
 
 

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VASRD CODE  RATING 

40% 
40% 

5025 

COMBINED 

Fibromyalgia with Chronic Neck and Back Pain and Headaches 

UNFITTING CONDITION 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120123, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 

            

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              COMMANDER, NAVY PERSONNEL COMMAND 
                                        

MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS 
 
 
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS           
 
Ref:   (a) DoDI 6040.44 
          (b) PDBR ltr dtd 12 Oct 12 ICO   
          (c) PDBR ltr dtd 17 Oct 12 ICO   
          (d) PDBR ltr dtd 22 Oct 12 ICO   
                               
1.  Pursuant to reference (a) I approve the recommendations of the Physical Disability Board of Review 
set forth in references (b) through (d). 
 
2.  The official records of the following individuals are to be corrected to reflect the stated disposition: 
 
 
Permanent Disability Retired List effective 18 March 2005. 

a.  former USN:  Disability retirement with a final disability rating of 30% with assignment to the 

 
b. former USMC:   Disability retirement with a final disability rating of 40% with assignment to 

the Permanent Disability Retired List effective 28 November 2008. 

 
c.   former USMC:  Disability retirement with a final disability rating of 30% and assignment to 

 

the Permanent Disability Retired List effective 15 March 2006. 
 
3.  Please ensure all necessary actions are taken, included the recoupment of disability severance pay if 
warranted, to implement these decisions and that subject members are notified once those actions are 
completed. 
 
 
 

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