RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

                             BRANCH OF SERVICE:  ARMY    

 
NAME:  XXXXXXXXXXXXXXXXX                 
CASE NUMBER:  PD1200674                                                            SEPARATION DATE:  20030620   
BOARD DATE:  20130207   
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  SSG/E-6  (54B,  Chemical  Ops  Specialist)  medically 
separated for spondylolisthesis L4 on L5 with degenerative disc disease of L4-5.  The CI could 
not be adequately rehabilitated to meet the requirements of his Military Occupational Specialty 
or physical fitness standards despite physical therapy (PT) and medication; he declined surgical 
intervention.  He was consequently issued a permanent L3 profile and referred for a Medical 
Evaluation Board (MEB).  The MEB forwarded two diagnoses to the PEB; “1) Spondylolisthesis 
L4 on L5,” and “2) degenerative disc disease L4-5,” as medically unacceptable IAW AR 40-501.  
No  other  conditions  were  submitted  by  the  MEB.    The  CI  disagreed  with  the  MEB  pain 
characterization, which was addressed by the MEB approving authority.  The PEB adjudicated 
“spondylolisthesis L4 on L5 with degenerative disc disease of the L4-5…” as unfitting and rated 
10%  citing  “IAW  Department  of  Defense  (DoDI)  1332.29  and  AR  635-40.”    The  CI  made  no 
appeals and was medically separated with a 10% disability rating.   
 
 
CI CONTENTION:  The application states “My back conditions are irreversible and have lead to 
numerous other medical problems.  Numbness and chronic pain in back, hips and legs, migraine 
headaches,  acid  reflux  disease  from  the  numerous  medications,  knee  pain,  anger  issues, 
depression, also, on the Diagnosis of the Medical Eval Board Proceedings, I was diagnosed with 
2 separate conditions (1) Spondylolisthesis L4-L5 (2) Degenerative disc disease L4-5, but on the 
rating dicision they were combined and rated as 1 condition.   Also according to W--- A. S---, 
COL, the appeal to the dicision was solely based on the amount of narcotic medications I had 
been given in previous years.  They didn’t even consider the numerous other pain meds I was 
taking for chronic pain or all the physical therapy attended, back braces issued, physical profile 
limitations  for  3  plus  years  Additional  paperwork  attached.    A  list  of  medications  currently 
taking”[sic].  He does not elaborate further 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 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  unfitting 
spondylolisthesis  and  degenerative  disc  disease  are  addressed  below.    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 Service Board for Correction of Military 
Records.   
 
 
 
 
 

 
 
 
RATING COMPARISON:  
 

Service PEB – Dated 20030321 
Condition 
L4-5 Spondylolisthesis and 
Degenerative Disc Disease   5299-5295 

Code 

Rating 

10% 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

Code 

5293-5295 

VA (1 Mo. Pre-Separation) – Effective 20030621 
Condition 
Lower  Back  Degenerative  Disc 
Disease  and  Herniated  Nucleus 
Pulposus 
Right Ankle Sprain 
Left Knee Strain 
0% X 2  
Combined:  30% 

5271-5024 
5024 

Rating 

Exam 

10% 

10% 
10% 

20030512 

20030512 
20030512 
20030512 

 
 
ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding  the  significant  impairment  with  which  his  service-incurred  condition  continues  to 
burden  him.    The  Board  wishes  to  clarify  that  it  is  subject  to  the  same  laws  for  disability 
entitlements as those under which the Disability Evaluation System (DES) operates.  The DES 
has neither the role nor the authority to compensate service members for anticipated future 
severity or potential complications of conditions resulting in medical separation.  That role and 
authority is granted by Congress to the Department of Veterans Affairs (DVA), operating under 
a  different  set  of  laws  (Title  38,  United  States  Code).    The  Board  evaluates  DVA  evidence 
proximal to separation in arriving at its recommendations, but its authority resides in evaluating 
the  fairness  of  DES  fitness  decisions  and  rating  determinations  for  disability  at  the  time  of 
separation.   
 
Lower back Condition.  The narrative summary notes a 5-year history of lower back pain (LBP) 
dating to 1996 when the CI reported back pain after heavy lifting.  The pain was worse with 
physical activity and walking greater than 300 yards.  He reported stabbing pain in the lower 
back region with pins and needles in the left posterior leg to the bottom of his foot.  The CI 
reported  that  he  was  unable  to  sleep  because  of  the  pain.    He  was  treated  with  PT,  anti-
inflammatory medications, narcotic medication, and a back brace with intermittent relief of his 
symptoms.  A magnetic resonance imaging study revealed pars defect at the L 4 level with a 
significant  disc  bulge  at  L4-5  without  neuroforaminal  stenosis.    Physical  examination  on 
4 December 2002 (6 months prior to separation) documented forward flexion with fingers to 
toes  and  pain  at  the  extremes  of  motion.    Extension  and  lateral  bending  were  noted  as 
“adequate.”    There  was  diffuse  tenderness  over  the  left  paravertebral  area  at  L4-L5.    Motor 
strength was documented as 5/5 with a negative straight leg raise.  At the MEB examination, 3 
months prior to separation, the CI reported back pain that keeps him up at night and numbness 
in his legs.  He also reported use of a back brace for pain.  The MEB examination documented 
tenderness  to  palpation  along  the  left  paraspinal  area  at  L4-L5  with  decreased  flexion  and 
extension strength and a slightly decreased deep tendon reflex (DTR) at the left patella.  The 
examiner also noted an antalgic gait.  At VA Compensation and Pension examination a month 
prior to separation, the CI reported sharp back pain 3 times a week with normal activity.  He 
also reported left leg pain and numbness, an inability to lift greater than 20 pounds, inability to 
perform running or jarring activities, and an inability to stand greater than 20 minutes.  The 
examiner documented normal gait and posture, painful motion, and tenderness to palpation in 
the lower back.  The range of motion was normal: flexion to 90⁰, extension to 30⁰, left and right 

lateral flexion to 35⁰and left and right rotation to 30⁰.  Deluca factors of pain, fatigability, and 
lack of endurance with repetition were noted.  Sensation and DTR were intact.  Lasegue test 
elicited pain in the lower back.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  and  VA  each  assigned  a  10%  rating  under  similar  5295  (lumbosacral  strain)  coding 
pathways.    The  PEB  rated  analogously  while  the  VA  combined  the  5293  code  (intervertebral 
disc syndrome).  The Board agreed that elements of the 20% rating under the 5295 code were 
not present on any of the cited examinations, and further noted that there was no evidence of 
“incapacitating  episodes”  that  would  justify  a  minimal  rating  under  the  5293  code.    Board 
members also agreed that there was no evidence to support a higher rating under the 5292 
code  (limitation  of  lumbar  motion).    The  Board  further  considered  that  two  diagnoses, 
spondylolisthesis of L4 on L5 and degenerative disc disease of L4-5, were forwarded by the MEB 
as  not  meeting  retention  standards.    However,  because  the  pain  manifested  by  one  is 
indistinguishable  from  the  other,  the  Board  concluded  that  assigning  separate  ratings  would 
not comply with Veterans Affairs Schedule for Rating Disabilities (VASRD) §4.14 (Avoidance of 
pyramiding).  The Board finally deliberated if additional disability was justified for the history of 
lower  extremity  pain  and  numbness.    However,  the  evidence of  record  did  not demonstrate 
functional impairment due to radiculopathy at the time of separation, and the Board therefore 
concludes  that  additional  disability  was  not  justified  on  this  basis.    After  due  deliberation, 
considering all of the evidence and mindful of VASRD §4.3 (Resolution of reasonable doubt), the 
Board  concluded  that  there  was  insufficient  cause  to  recommend  a  change  in  the  PEB 
adjudication of the 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.  As discussed above, PEB 
reliance  on  (DoDI)  1332.29  and  AR  635-40  for  rating  spondylolisthesis  L4  on  L5  with 
degenerative  disc  disease  was  operant  in  this  case  and  it  was  adjudicated  independently  of 
those policies by the Board.  In the matter of the spondylolisthesis L4 on L5 with degenerative 
disc disease condition and IAW 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 that there be no recharacterization of 
the CI’s disability and separation determination. 
 

VASRD CODE  RATING 
5299-5295 
COMBINED 

10% 
10% 

UNFITTING CONDITION 
Spondylolisthesis L4 on L5 With Degenerative Disc Disease 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120613, w/atchs. 
Exhibit B.  Service Treatment Record. 
Exhibit C.  Department of Veterans Affairs Treatment Record. 
 

 
 
 
 
 
 
 
 

           XXXXXXXXXXXXXXXXXX, DAF 
           Director 
           Physical Disability Board of Review 

 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / xxxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation 
for xxxxxxxxxxxxxxxxx, AR20130003760 (PD201200674) 
 
 
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 
 
 
 

     xxxxxxxxxxxxxxxxxxxx 
     Deputy Assistant Secretary 
         (Army Review Boards)