RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

 
NAME:  XXXXXXXXX 
BRANCH OF SERVICE:  ARMY 
CASE:  PD1200779                                                                                    SEPARATION DATE:  20020629 
BOARD DATE:  20121218 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty,  SGT/E-5,  (97B20/Counterintelligence  Agent) 
medically  separated  for  a  thoracolumbar  spine  condition.    He  suffered  persistent  pain  after 
injuring  his  back  in  1997,  and  was  ultimately  diagnosed  with  thoracic  disc  disease  without 
surgical indications.  He did not respond adequately to conservative measures, and was unable 
to perform within his Military Occupational Specialty (MOS) or meet physical fitness standards.  
He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB).  The 
back  condition  was  forwarded  to  the  Informal  Physical  Evaluation  Board  (IPEB)  as  two 
diagnoses, “T-7-8 degenerative disk disease with disk bulge” and “chronic back pain,” IAW AR 
40-501.    No  other  conditions  appeared  on  the  MEB’s  submission.    The  IPEB  appropriately 
combined the separate thoracic and lumbar diagnoses as a single unfitting condition (“chronic 
back  pain  with  degenerative  T7-T8  disc  disease”),  rated  10%,  citing  criteria  of  the  Veterans 
Administration  Schedule  for  Rating  Disabilities  (VASRD).    The  CI  appealed  to  a  Formal  PEB 
(FPEB), which affirmed the IPEB finding and rating; and, was thus medically separated with a 
10% disability rating.   
 
 
CI CONTENTION: “Board failed to consider all injuries sustained in the line of duty.  VA records 
indicate  hip,  knee,  neck  and  skull  fracture  as  service  connected  despite  knowing  of  these  at 
time of separation.  Board only considered the single disk between T7-T8.  Within a few months 
I was seen at an emergency room for a full spine “spasm” that caused visible muscle rigidity 
from my head to my legs.  I have had to live with the risk of sudden onset back pain severe at 
first, but now usually mild due to weekly chiropractic and physical therapy...  Due to service 
connected  head  injury  I  suffer  from  chronic  headaches.    Knee,  hip  and  back  problems  have 
made exercise less enjoyable (painful) especially in the colder months. ” 
 
 
SCOPE OF REVIEW:   
 
The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2).  It is 
limited to those conditions determined by the PEB to be unfitting for continued military and 
those  conditions  identified  but  not  determined  to  be  unfitting  by  the  PEB  when  specifically 
requested by the CI.  The rating for the unfitting spine condition is addressed below.  The hip, 
knee,  neck,  skull  fracture,  and  headache  conditions,  and  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.   
 
IAW DoDI 6040.44, the Board’s authority is limited to making recommendations on correcting 
disability determinations.  The Board’s role is thus confined to the review of medical records 
and  all  evidence  at  hand  to  assess  the  fairness  of  PEB  rating  determinations,  compared  to 
Veteran’s Affairs Schedule for Rating Disabilities (VASRD), based on ratable severity at the time 
of  separation.      The  Board  acknowledges  the  CI’s  information  regarding  the  significant 
impairment with which his service-connected conditions continues to burden him; but, must 
emphasize that the Disability Evaluation System (DES) has neither the role nor the authority to 
compensate 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.  
 
 
RATING COMPARISON:   
 

Service FPEB – Dated 20020405 
Code 
Condition 
5299-
5295 

Chronic Back Pain/Degenerative 
T7-T8 Disc Disease 

Rating 

10% 

No Additional MEB/PEB Entries 

VA (1 Mo. Pre-Separation) - VARD 20020613  
Condition 
Thoracic Disc Disease 
Recurrent Lumbosacral Strain 
Left Shoulder Strain 
Muscular Tension Headaches 

Rating 
10% 
0% 
10% 
10% 

Code 
5291 
5295 

5299-5019 

8045  

0% X 1 / Not Service-Connected x 3 

Exam 

20020530 
20020530 
20020530 
20020530 
20020530 

Combined:  10% 

Combined:  30% 

 
 
ANALYSIS SUMMARY:   
 
Chronic Back Pain Condition.  The CI first injured his back in a truck accident in October 1997.  
He initially recovered, but experienced a recurrence of pain the following year preceding his 
entry  on  active  duty  in  1999.    He  fell  while  ruck  marching  in  June  2001  and  his  symptoms 
worsened.  Magnetic resonance imaging (MRI) in November 2001 demonstrated a disc bulge at 
T-7/8 with cord encroachment, but no nerve root compromise.  A neurosurgical consultant a 
month  later  opined  that  there  was  no  surgical  indication.    Although  subsequent  trials  of 
physical therapy (PT), chiropractic intervention, and medication resulted in some improvement; 
the CI continued to suffer pain incompatible with his duties.  The pain was predominantly mid-
back, with a low back component; and, no radiation or neurological symptoms were reported.  
The narrative summary (NARSUM) noted worsening pain, but a stable condition.  The physical 
exam provided detailed normal neurological findings, but not general spine findings.  Range-of-
motion (ROM) measurements from PT were attached to the NARSUM, recording a flexion of 40 
degrees (normal 90 degrees) and minimal limitations in other planes.  At the VA Compensation 
and Pension (C&P) exam (a month prior to separation), the examiner stated, “[CI] continues to 
complain of daily low back pain ... especially after sitting in one position for a long period of 
time.  He reports no radicular symptoms.”  The VA physical exam noted a normal gait and spinal 
contour, no spasm, and normal neurological findings.  The ROM measurements were separated 
into thoracic and lumbar segments, yielding thoracic flexion of 50 degrees and lumbar flexion of 
95 degrees; combined ROM (incomplete) was normal for both thoracic and lumbar segments.  
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
2002 VASRD coding and rating standards for the spine, which must be applied to the Board’s 
recommendation IAW DoDI 6040.44, differ significantly from the current §4.71a general rating 
formula for the spine.  The earlier criteria were more subject to the rater’s opinion regarding 
degree of severity, as opposed to the more objective current standards with quantifiable rating 
thresholds grounded in ROM measurements.  The PEB’s 10% rating under 5295 (lumbosacral 
strain) quoted the criterion of “characteristic pain on motion” as per the rating language; and, 
the  next  higher  (20%)  rating  under  the  code  requires  “muscle  spasm  on  extreme  forward 
bending, loss of lateral spine motion, unilateral, in standing position.”  The latter criteria are not 
in  evidence.    The  VA  10%  rating  under  5291  was  for  ‘moderate’  limitation  of  motion  of  the 
thoracic  spine.    The  VA’s  second  0%  rating  under  5295  is  not  eligible  for  consideration  as  a 
second  compensable  rating,  since  separate  thoracic  and 
lumbar  disability  cannot  be 
distinguished  by  the  Army  or  VA  evidence. 
  Members  agreed  that  the  MEB’s  ROM 
measurements, along with the VA’s thoracic ROM measurements, quite reasonably justified a 
moderate-level  rating  for  limitation  of  motion;  and,  it  was  further  deliberated  whether 

2                                                           PD1200779 

 

application of 5292 for lumbar ROM, yielding a 20% rating for moderate limitation, could be 
justified  in  lieu  of  the  5291  code  for  thoracic  ROM.    It  was  agreed,  however,  that  since  the 
pathology was clearly more attributable to the thoracic spine, and since the VA lumbar ROMs 
did not support the higher rating under 5292; the thoracic code 5291 should serve as the rating 
benchmark.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 
(reasonable doubt), the Board recommends no change in the 10% rating of the thoracolumbar 
spine condition; although, a change in VASRD code to 5291 is indicated to support the Board’s 
rating rationale.   
 
 
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 spine condition, the Board unanimously recommends a 
disability rating of 10%, coded 5291 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 

5291 

COMBINED 

10% 
10% 

Chronic Back Pain with Thoracic Degenerative Disc Disease 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120609, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           xxxxxxxxxxxxxx 
           Director 
           Physical Disability Board of Review 

3                                                           PD1200779 

 

 
 

 
 
 

 
 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / xxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for xxxxxxxxxxxxx, AR20130001979 (PD201200779) 
 
 
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 description 
without modification of the combined rating or 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 
 
 
 
 

     XXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards) 

 
 
 

 
 
 

 
 
 

 
 
 

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