RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  ARMY 
SEPARATION DATE:  20040908 

 
NAME:  XXXXXXXXXXXXXXX 
CASE NUMBER:  PD1200235 
BOARD DATE:  20130221 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  SGT/E-5  (88M20/Motor  Transport  Operator) 
medically separated for bipolar disorder and chronic subjective back pain.  The CI suffered a 
severe back injury when he was in a motor vehicle accident (MVA) with his truck in Iraq.  This 
accident  triggered  a  significant  mood  disturbance  as  well  as  exacerbated  a  history  of 
intermittent  explosive  disorder-type  symptoms.    Despite  medications,  steroid  injections, 
physical therapy (PT) for the back injury and intensive mental health treatment for the bipolar 
disorder, the CI failed to meet the physical requirements of his Military Occupational Specialty 
(MOS)  or  satisfy  physical  fitness  standards.    He  was  issued  a  permanent  L3/S4  profile  and 
referred for a Medical Evaluation Board (MEB).  The MEB forwarded AXIS I:  bipolar disorder not 
otherwise specified (NOS) and low back pain (LBP) secondary to L4-L5 disk herniation to the 
Informal  Physical  Evaluation  Board  (IPEB).    The  MEB  forwarded  no  other  conditions  for  IPEB 
adjudication.    The  IPEB  adjudicated  the  bipolar  disorder  and  chronic  subjective  back  pain 
without neurological abnormality conditions as unfitting, rated 10% and 10%, with application 
of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD).  The CI appealed to the Formal 
PEB (FPEB) that reaffirmed the IPEB’s adjudication.  The CI filed a Nonconcurrence to the FPEB 
findings and a Congressional Inquiry was initiated on his behalf.  After review by the PEB and 
the US Army Physical Disability Agency (USAPDA), an Administrative Correction FPEB DA Form 
199 was issued with no change in the disability ratings.  The CI appealed to the Army Board for 
Correction of  Military  Records  (ABCMR).    The  ABCMR  denied the  application  and the  CI  was 
then medically separated with a combined 20% disability rating. 
 
 
CI  CONTENTION:    “1.  UNDERRATED  ON  THE  FOLLOWING  CONDITIONS:  PTSD  10%  AND  BACK 
CONDITION  10%.    2.    WHILE  SERVING  CONTINUOUS  TREATMENT  FOR  MIGRAINES  WAS 
PROVIDED BUT WAS NEVER RATED OR ADRESSED.  3.  NOT RATED/TESTED FOR: SLEEP APNEA, 
TINNITUS AND TRAUMATIC BRAIN INJURY.  DUE TO MY TBI I’M CURRENTLY FACING LOSS OF 
VISION THAT’S BEEN ADDRESSED BY THE VA.” 
 
 
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  unfitting  mental  health  (bipolar 
disorder) and back conditions requested for consideration meet the criteria prescribed in DoDI 
6040.44 for Board purview, and are accordingly addressed below.  The requested conditions of 
posttraumatic  stress  disorder  (PTSD),  migraines,  sleep  apnea,  tinnitus,  traumatic  brain  injury 
(TBI), and vision problems are not within the Board’s purview.   
 

 

Service FPEB – Dated 20040604 
Condition 

Code 
9432 

Rating 
10% 

5299-5237 

10% 

Bipolar Disorder 
Chronic Subjective Back 
Pain without Neurologic 
Abnormality 

VA (6 Mos. Post-Separation) – All Effective Date 20040909 

Condition 

Bipolar Disorder 
Herniated Nucleus Pulposus, L4-
5 and L5-S1 

Code 
9432 

Rating 
10%* 

5299-5243 

20% 

Exam 
STR 

STR 

N/A 

RATING COMPARISON:   
 

↓No Additional MEB/PEB Entries↓ 

Combined:  20% 

0% X 1 / Not Service-Connected x 2 

Combined:  30% 

*Bipolar D/O rating increased to 30% effective 20050208 based on first Mental Health C&P exam 20050328.  Previous rating 
was based on service treatment record (STR).  Later changed to bipolar D/O and PTSD and increased to 50% effective 20080229 
based on VA treatment records and a C&P examination from 20080829. 
 
ANALYSIS SUMMARY:  The Board’s authority as defined in DoDI 6040.44, resides in evaluating 
the fairness of Disability Evaluation System (DES) fitness determinations and rating decisions for 
disability at the time of separation.  The Board utilizes VA 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.  Post-separation evidence is probative only to the 
extent  that  it  reasonably  reflects  the  disability  and  fitness  implications  at  the  time  of 
separation. 
 
Bipolar  Disorder  Condition.    The  CI  was  first  evaluated  by  combat  stress  in  theater  after the 
MVA triggered significant mood disturbance.  In May 2003, the mental health screener noted 
the CI had moderate symptoms and further psychological evaluation was indicated.  The MEB 
narrative summary (NARSUM), completed 7 months prior to separation, documented that the 
CI was referred for psychiatric evaluation during the medical processing that occurred when he 
was evacuated to Fort Campbell KY for this back condition.  The CI was first seen by mental 
health  in  October  2003.    He  first  saw  the  provider  that  completed  the  MEB  NARSUM  on 
10 November 2003 and endorsed mood swings.  The CI was seen for follow-up 4 days later and 
although his judgment and insight appeared appropriate, the examiner diagnosed “mood and 
anxiety  disorder  not  otherwise  specified  with  elements  of  Post-Traumatic  Stress  Disorder 
(PTSD) and then again his history probably consistent with intermittent explosive disorder.”  He 
was eventually diagnosed with bipolar disorder.  Although the NARSUM does not state when 
Lithium was started, the CI had a therapeutic level on 3 December 2003.  The CI was issued a 
permanent S4 profile by psychiatry in November 2003 and the MEB was initiated.  The profile 
was combined with the permanent L3 profile for back pain in late December 2003. 
 
In mid-December 2003, the CI continued to endorse feelings of anxiety and fatigue; however, 
on follow-up with the psychiatrist he seemed to be responding to a trial of Lithium.  He had also 
started  Gabapentin  for  his  chronic  pain  and  this  may  have  benefitted  his  mental  health 
condition.  The MEB NARSUM mental status examination (MSE) was completed on 26 January 
2004, approximately 7 months prior to separation.  At that time, the CI reported he was still 
depressed  and  it  had  been  a  difficult  month  because  he  had  re-injured  his  back.    He  also 
described an incident where his dog acted out and he thought he would have killed the dog if 
his  wife  had  not  been  there.    He  thought  the  Lithium  was  helping  and  wanted  to  continue 
taking it along with his gabapentin.  He was also taking Seroquel to help with insomnia.  At the 
time of the MEB, the MSE noted a tired or depressed mood and his affect was both tired and 
restricted.  He admitted to feeling being watched and denied auditory or visual hallucinations 
but at times heard weird noises.  He was considered a highly reliable historian and his history 
was  corroborated  by  his  wife.    The  diagnosis  was  bipolar  disorder  NOS,  moderate,  with 
elements of intermittent explosive disorder and PTSD subsumed under the bipolar disorder and 
not warranting a separate diagnosis.  The condition was considered to have marked impairment 
for military duty and definite impairment for social and industrial adaptability.  The condition 
was manifested by persistent irritable moods states sometimes associated with high energy and 

2                                                           PD1200235 
 

high  activities  level  suggestive  of hypomania  as well  as  depressed  and tired  states  where  he 
would  spend  most  of  the  day  inactive  with  difficulty  concentrating,  difficulty  sleeping,  and 
difficulty with goal directed activity.  He also noted grossly disproportionate responses to minor 
irritations to which he has insight.  The examiner also noted anti-social traits, but doubted the 
presence of a true antisocial personality disorder.  The overall Global Assessment of Functioning 
(GAF) was 55, in the range of moderate symptoms. 
 
A VA mental health clinic note in January 2005 noted that the CI had just been released from a 
6-day inpatient stay at Cumberland Hall for depression and suicidal ideations.  At the clinic visit, 
the  CI  endorsed  symptoms  of  paranoia,  sleep  disturbances,  nightmares,  exaggerated  startle 
responses, self-isolation, waking up from sleep fighting-causing him to hit the wall and punch 
his wife, and decreased appetite.  The examiner diagnosed major depressive disorder (MDD), 
severe and recurrent, without psychotic features and PTSD.  The GAF was 50--in the range of 
serious symptoms.  A VA psychiatric treatment note from 4 March 2005 documented significant 
symptoms of both bipolar disorder and PTSD.  The MSE noted a dysphoric mood and a blunted 
flat affect.  He continued to have feelings of mild paranoia thinking people were watching him 
or looking at him.  No GAF was noted but at the time of this examination, the CI was pursuing a 
degree  in  nursing,  attending  school  at  night,  and  he  reported  he  was  doing  very  well  in  his 
academic  work.    He  also  reported  he  was  going  to  start  working  full  time  at  a  Wal-Mart 
distribution center.  He had been working with his friends doing various odd jobs. 
 
The  VA  mental  health  Compensation  &  Pension  (C&P)  examination  approximately  7  months 
after  separation  noted  a  significant  inpatient  hospitalization  that  took  place  28  April  2000 
through  3  January  2005  for  depression  and  suicidal  ideations.    The  MSE  documented  a 
depressed mood and a dysphoric affect.  The CI had difficulty recalling historic events and his 
thought  content  was  significant  for  some  paranoia  with  thoughts  that people  are  out  to  get 
him.  He also reported he had been involved in almost ten physically violent altercations after 
he had been discharged from the military.  Additionally, the CI reported feelings of depressed 
mood, dysphoric affect, paranoia, mood swings, nightmares, loss of appetite, loss of interest, 
irritability  and  anger,  nervousness,  autonomic  hyperarousal,  feelings  of  detachment  from 
others, feelings of internal numbness, feelings of nervousness, and feelings of elevated mood at 
times.    A  Personality  Assessment  Inventory  (PAI)  was  completed  and  while  there  was  some 
evidence  the  CI  did  not  answer  in  a  completely  forthright  manner  and  that  could  lead  to 
inaccurate impressions, there was no evidence he attempted to either exaggerate or minimize 
his symptoms.  The results appeared to be congruent with other information from the available 
record,  including  problems  with  depression,  isolation,  insomnia,  interpersonal  relationships, 
ability to control his own impulses, and fairly rapid and extreme mood swings.  The examiner 
noted a diagnosis of AXIS I bipolar II disorder, most recent episode depressed, moderate but 
previously  severe  with psychotic features.   He also  noted  a  second  AXIS  I  diagnosis  of  PTSD, 
mild,  and  an  AXIS  IV  diagnosis  of  marital  problems,  inadequate  social  support,  and  difficulty 
maintaining employment.  The overall GAF was 55 in the range of moderate symptoms.  The 
C&P examination noted the CI had begun working as a security guard in January 2005, but was 
fired for being late multiple times.  Two weeks prior to the examination, he had started working 
at  a  Wal-Mart  distribution  center.    He  also  reported  working on his  RN  degree.   There is  no 
information on how the CI was performing either at work or at school.  The CI was married but 
had marital difficulties and he reported he had a few friends.  The next C&P examination was 
completed  in  August  2008  and  it  included  documentation  of  a  second  hospitalization  for 
suicidal ideation in 2007.  He reported he had depressed moods that lasted a few weeks and 
stated he typically did not go to work or would leave early during these periods.  Occupation 
was listed as full time clerical for the last one to 2 years with at least 12 weeks of work lost due 
to psychiatric problems.  The exam also noted the CI was going to college, one class at a time, 
for human services to work with veterans.  There was no mention of a nursing degree.  
 

3                                                           PD1200235 
 

The Board directs its attention to the question of applicability of §4.129, mental disorders due 
to traumatic stress, and the rating recommendation based on the evidence just described.  The 
PEB rating, as described above, was derived from DoDI 1332.39 and preceded the promulgation 
of the National Defense Authorization Act (NDAA) 2008 mandate for DoD adherence to VASRD 
§4.129.    The  Board  noted  that  psychiatric  NARSUM  stated  the  CI’s  bipolar  disorder  was 
triggered by the MVA in Iraq.  While the MEB psychiatrist opined a separate diagnosis of PTSD 
was  not  warranted,  the  PEB  included  this  diagnosis  along  with  bipolar  disorder  as  the  CI’s 
unfitting condition.  At the C&P examination, a moderate bipolar disorder was diagnosed along 
with mild PTSD.  However, a diagnosis of PTSD is not required for application of VASRD §4.129.  
The  VASRD  states,  “When  a  mental  disorder  that  develops  in  service  as  a  result  of  a  highly 
stressful  event  is  severe  enough  to  bring  about  the  veteran’s  release  from  active  military 
service, the rating agency shall assign an evaluation of not less than 50 percent and schedule an 
examination  within  the  six  month  period  following  the  veteran’s  discharge  to  determine 
whether a change in evaluation is warranted.”  IAW DoDI 6040.44 and VASRD §4.129, the Board 
is  obligated  to  recommend  a  minimum  50%  rating  for  a  retroactive  6-month  period  on  the 
Temporary Disability Retired List (TDRL).  Whether or not the CI is considered to have had PTSD 
as a separate diagnosis at the time of separation, the Board determined that §4.129 should be 
applied.  The psychiatric MEB NARSUM does not support a rating greater than 50% at the time 
of separation and therefore, an initial 50% disability rating for code 9432 (Bipolar disorder) is 
recommended.  
 
The Board must then determine the most appropriate fit with VASRD 4.130 criteria at 6 months 
for its permanent rating recommendation.  The proximate source of comprehensive evidence 
on which to base the permanent rating recommendation in this case is the C&P examination 
performed  approximately  7  months  after  separation.    The  Board  directs  attention  to  its 
permanent  rating  recommendation  based  on  the  above  evidence.    The  VA  chose  the  same 
disability  code  as  the  PEB,  9432  (Bipolar  D/O).    The  VA  initially  rated  the  bipolar  disorder 
condition  10%  based on  the  service treatment  record  (STR),  however  the  5  May  2005  VARD 
increased the rating to 30% effective 8 February 2005 based on the initial C&P mental health 
examination completed in March 2005, approximately 7 months after separation. 
 
The Board agreed that the mental health C&P examination from March 2005 was closest to the 
6-month  point  after  separation  and  therefore  this  examination  is  assigned  the  greatest 
probative  value  in  determining  the  permanent  rating  recommendation.    Based  on  this 
examination and VA treatment records from December 2004 to January 2005 (3 to 4 months 
after separation), the VA assigned a 30% disability rating for 9432 (bipolar disorder).  The rating 
decision  noted  a  moderate  impairment  in  the  vocational  arena  and  a  mild  to  moderate 
impairment in the social arena.  
 
All  Board  members  agreed  that  the  50%  threshold  was  not  approached.    The  Board  then 
considered the criteria of the 30% rating [Occupational and social impairment with occasional 
decrease in work efficiency and intermittent periods of inability to perform occupational tasks 
(although generally functioning satisfactorily, with routine behavior, self-care, and conversation 
normal)] versus the 10% rating (occupational and social impairment due to mild or transient 
symptoms which decrease work efficiency and ability to perform occupational tasks only during 
periods  of  significant  stress,  or;  symptoms  controlled  by  continuous  medication).    The  C&P 
examiner  had  opined  the  CI’s  post-military  psychosocial  functioning  seemed  fair  to  poor  as 
evidenced  by  the  fact  that  the  CI  had  problems  containing  his  anger  in  public,  he  had  lost 
interest in activities, had some difficulty maintaining employment, and had marital difficulties.  
The CI also had continued symptoms of  depression, paranoia, mood swings, nightmares, loss of 
appetite, 
irritability  and  anger,  nervousness,  autonomic 
hyperarousal, detachment from others, internal numbness, nervousness, and elevated mood at 
times.  There is no evidence of any symptom free periods and his symptoms were neither mild 
nor transient.  While the record does show employment and attendance at school, the available 

in  activities, 

loss  of 

interest 

4                                                           PD1200235 
 

Thoracolumbar ROM 
Flexion (90⁰ Normal) 

Ext (0-30) 

R Lat Flex (0-30) 
L Lat Flex 0-30) 
R Rotation (0-30) 
L Rotation (0-30) 
Combined (240⁰) 

Comment 

MEB ~8 Months Pre-Separation 

 

35⁰ 
10⁰ 

15⁰ with pain 
10⁰ with pain 

30° (45⁰) with pain 

30° (45⁰) 

140⁰ 

VA C&P ~45 Months Post-Separation 

60⁰ 
15⁰ 
30⁰ 
30⁰ 
30⁰ 
30⁰ 
195⁰ 

Cane; guarding; pain with motion 
tenderness; antalgic gait; 

facts  suggest  he  was  not  successful  in  either  endeavor.    He  was  not  able  to  maintain 
employment at any one place.  It also appears that he was not able to maintain any significant 
load  of  coursework  and  changed  from  studying  nursing  to  human  services,  a  much  less 
intellectually  challenging  major.    After  due  deliberation,  considering  all  of  the  evidence  and 
mindful  of  VASRD  §4.3  (reasonable  doubt),  the  Board  recommends  a  permanent  disability 
rating of 30% for the bipolar disorder condition.   
 
Chronic  Subjective  Back  Pain  Condition.   There were  two  ROM  evaluations  in evidence,  with 
documentation of additional ratable criteria, which the Board weighed in arriving at its rating 
recommendation; as summarized in the chart below.   

PT exam:  Measured with inclinometer; slow antalgic 
gait with cane; cogwheel movements with extension; 
pain 10/10.  
NARSUM:  “constant moderate pain with occasional 
episodes marked pain” 

§4.71a Rating 

20% (PEB 10%) 

20% 

 
The CI’s back pain is well documented in the numerous entries in the STR dated from June 1999 
through August 2006.  After the accident in Iraq, the CI was evaluated in theater by Neurology 
in  May  2003  for  right  lower  extremity  radicular  symptoms.    He  was  then  evacuated  to  Fort 
Campbell  for  further  evaluation.    Magnetic  resonance  imaging  (MRI)  in  June  2003  revealed 
abnormal disc herniations with broad based disc bulges at L4-5 level and L5-S1, along with mild 
bilateral  foraminal  stenosis  and  ventral  thecal  sac  effacement,  but  without  significant  spinal 
stenosis at L4-5 and L5-S1.  The orthopedics evaluation in June 2003 noted normal motor and 
sensory exams and the CI was referred to physical therapy and pain management.  A repeat 
MRI in September 2003 was unchanged from the initial exam.  A third MRI in May 2004 also 
documented  right  paracentral  herniated  disks  at  L4  and  L5.    Lumbar  X-rays  from  May  2004 
were  normal  with  a  questionable  narrowing  of  the  L5  disk  space.    The  CI  continued  with 
complaints  of  severe  LBP  shooting  down  to  the  lower  extremities  greater  on  the  right  with 
tingling, numbness, and weakness in the legs.  An electromyogram and nerve conduction study 
(EMG/NCS) study of bilateral lower extremities in September 2003 demonstrated no evidence 
of radiculopathy from L2 to S1 and no evidence of bilateral lower extremity peripheral sensory 
motor neuropathy, peroneal neuropathy, or tibial neuropathy.  A repeat EMG/NCS in October 
2003 was also normal.  A neurologic evaluation in October 2003 documented a normal base 
and antalgic baseline gait with careful but symmetric step length and arm swing, and normal 
turn.  The CI was able to toe, heel, and tandem walk.  Straight leg raise (SLR) testing produced 
low  back  discomfort  without  radiation  at  80  degrees  bilaterally.    Reflexes  were  symmetric 
bilaterally with lower extremities 2+ and 3 and upper extremities 1+ and 2.  Sensory exam of 
the lower extremities was normal except pinprick sensation decreased over the right foot, in 
the  medial  and  lateral  surfaces, medial  malleolus,  and  sole.   Motor  exam  was  5/5  bilaterally 
except 4/5 for the right quadriceps and 5-/5 for the right hamstring and ankle eversion. 
 
The MEB NARSUM completed 7 months prior to separation documented that the CI had severe 
pain with numbness and tingling that radiated down the left side of his body when he walked 
and that he required a cane to help support the left side of his body while he walked.  At the 
time  of this  NARSUM,  the  CI  had  tried  and  failed  extensive  rehabilitation,  traction,  electrical 

5                                                           PD1200235 
 

stimulation  epidural  steroid  blocks,  and  multiple  nonsteroidal  anti-inflammatory  drugs 
(NSAIDS).    The  MEB  NARSUM  reported  exam  findings  from  a  physical  therapy  evaluation  on 
26 January 2004 and the information from the source document are summarized in the chart 
above.  These ROM measurements were made with an inclinometer, not a goniometer.  The CI 
was evaluated by the VA to establish care in December 2004 but no C&P exam was completed 
until  June  2008.    The  examiner  in  December  2004  noted  complaints  of  radicular  symptoms 
however,  gait,  reflexes,  motor,  and  sensory  findings  were  normal.    A  repeat  EMG  done  in 
January 2005  revealed normal findings  in  the  left  lower  extremity  (the  right  lower  extremity 
was not tested).   
 
Board  precedent  is  that  a  functional  impairment  tied  to  fitness  is  required  to  support  a 
recommendation for addition of a peripheral nerve rating at separation.  The pain component 
of  a  radiculopathy  is  subsumed  under  the  general  spine  rating  as  specified  in  §4.71a.    The 
sensory  component  in  this  case  has  no  functional  implications.    There  was  no  motor 
impairment in this case and the CI underwent multiple EMGs before and after separation that 
were  all  normal.    Since  no  evidence  of  functional  impairment  exists  in  this  case,  the  Board 
cannot support a recommendation for additional rating based on peripheral nerve impairment. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
FPEB  coded  the  chronic  subjective  back  pain  condition  analogous  to  5237  (Lumbosacral  or 
cervical  strain)  and  rated  10%.    The  VA  coded  the  back  condition  analogous  to  5243 
(Intervertebral disc syndrome) and rated 20% based on information from the STR.  With the 
constructed  TDRL  period  required  by  VASRD  §4.129,  the  Board  must  determine  disability 
ratings relevant for the time of separation and entrance onto the constructed TDRL period and 
for the time at the end of this constructed TDRL.  The General Rating Formula for Diseases and 
Injuries of the Spine considers the CI’s pain symptoms “With or without symptoms such as pain 
(whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of 
injury or disease.”  The MEB NARSUM examination met the 20% criteria “Forward flexion of the 
thoracolumbar  spine  greater  than  30  degrees  but  not  greater  than  60  degrees.”    While  the 
NARSUM  ROM  measurements  were  made  with  an  inclinometer  and  not  a  goniometer,  the 
record supports the finding that the CI had severely limited ROM on flexion with an antalgic gait 
and he required the use of a cane to help support the left side of his body when walking.  An 
antalgic gait due to muscle spasm or guarding also warrants a 20% rating.  While there is no 
evidence of muscle spasm, the CI did have painful motion and guarding can be assumed to have 
been present.    After  due  deliberation,  considering  all  of the  evidence  and  mindful  of  VASRD 
§4.3  (Reasonable  doubt),  the  Board  recommends  a  disability  rating  of  20%  for  the  chronic 
subjective back pain condition without neurologic abnormality at the time of entrance into the 
constructed TDRL period. 
 
Although  the  first  C&P  examination  was  not  completed  until  June  2008,  the  VA  treatment 
record documents a continuous history treatment for significant of back pain.  The 2008 C&P 
examination ROM measurements were made with a goniometer and they support a 20% rating.  
This examination also documents a persistent antalgic gait.  After due deliberation, considering 
all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a 
permanent  disability  rating  of  20%  for  the  chronic  subjective  back  pain  condition  without 
neurologic abnormality. 
 
 
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  bipolar  disorder  condition,  the  Board  unanimously 

6                                                           PD1200235 
 

recommends  a  TDRL  disability  rating  of  50%,  IAW  with  VASRD  §4.129  and  unanimously 
recommends  a  permanent  disability  rating  of  30%,  coded  9432  IAW  VASRD  §4.130.    In  the 
matter  of  the  chronic  subjective  back  pain  condition,  the  Board  unanimously  recommends  a 
20% disability rating for both the TDRL and the permanent disability ratings, with both coded 
5299-5237  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;  and,  that the discharge  with  severance pay  be  recharacterized to  reflect  permanent 
disability retirement, effective as of the date of his prior medical separation: 
 

UNFITTING CONDITION 

Bipolar Disorder 
Chronic Subjective Back Pain without Neurologic 
Abnormality 

VASRD CODE 

9432 

5299-5237 
COMBINED 

RATING 

TDRL  PERMANENT 
50% 
20% 
60% 

30% 
20% 
40% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 2010307 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 

 

 

xxxxxxxxxxxxxxxxxxxxxxxx, DAF 
Acting Director 
Physical Disability Board of Review 

7                                                           PD1200235 
 

SFMR-RB 
 

 

 
 

 

 

 
 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency  

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

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  

for xxxxxxxxxxxxxxxxxxxxxxx, AR20130003762 (PD201200235) 

 
 

 
 

 
 

 

 

 

 

 

 
 
 
 

 

 
 
 
 
 

1.  Under the authority of Title 10, United States Code, section 1554(a), I approve the enclosed 
recommendation of the Department of Defense Physical Disability Board of Review (DoD PDBR) 

pertaining to the individual named in the subject line above to  constructively place the 

individual on the Temporary Disability Retired List (TDRL) at  

60% disability for six months effective the date of the individual’s original medical separation 
for disability with severance pay and then following this six month period recharacterize the 
individual’s separation as a permanent disability retirement with the combined disability rating 

of 40%. 

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: 

 
a.  Providing a correction to the individual’s separation document showing that the 
individual was separated by reason of temporary disability effective the date of the original 

medical separation for disability with severance pay. 

 

b.  Providing orders showing that the individual was retired with permanent disability 

effective the day following the six month TDRL period. 

 
c.  Adjusting pay and allowances accordingly.  Pay and allowance adjustment will 
account for recoupment of severance pay, provide 60% retired pay for the constructive 
temporary disability retired six month period effective the date of the individual’s original 

medical separation and then payment of permanent disability retired pay at 40% effective the 

day following the constructive six month TDRL period.   

 

d.  Affording the individual the opportunity to elect Survivor Benefit Plan (SBP) and 

medical TRICARE retiree options. 

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: 

8                                                           PD1200235 
 

 

Encl 
 

 

 

 

 

 

 

 

 

 

 

 

 

     xxxxxxxxxxxxxxxxxx 

     Deputy Assistant Secretary 
         (Army Review Boards) 

 

 

 

 

 

9                                                           PD1200235