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AF | PDBR | CY2012 | PD2012-00857
Original file (PD2012-00857.pdf) Auto-classification: Denied
RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:   ARMY 
SEPARATION DATE:  20010924 

 
NAME:  XXXXXXXXXXXXXXX 
CASE NUMBER:  PD1200857 
BOARD DATE:  20130109 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  SGT/E‐5  (71L/Administrative  Specialist),  medically 
separated  for  chronic  low  back  pain  (LBP).    The  CI  developed  LBP  that  did  not  improve 
adequately  with  treatment  to  meet  the  physical  requirements  of  his  Military  Occupational 
Specialty (MOS) or satisfy physical fitness standards.  He was issued a permanent P3 profile and 
later  was  referred  for  a  Medical  Evaluation  Board  (MEB).    The  MEB  forwarded  no  other 
conditions for Physical Evaluation Board (PEB) adjudication.  The PEB adjudicated the chronic 
LBP as unfitting, rated 10%, with application of the Department of Defense Instruction (DoDI) 
1332.39 and Army regulation.  The CI made no appeals, and was medically separated with a 
10% disability rating.   
 
 
CI CONTENTION:  “Degenerative Disc Disease”   
 
 
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 condition, chronic LBP, will be reviewed by the Board.  The other conditions rated 
by the VA at separation (headaches, pes planus) are not within the Board’s purview.  The CI's 
remaining contended conditions of right knee, left knee, eczema and non‐cardiac chest pain are 
also 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 20010611 

VA (25 Mos. Post‐Separation) – All Effective Date 20010925

 
 
ANALYSIS SUMMARY: 
 
Chronic low back pain.  The CI developed LBP about 7 years prior to MEB without specific injury.  
Magnetic  resonance 
lumbar  spine  27  January  2000  documents 
degenerative  changes  of  L5‐S1,  without  intervertebral  disc  protrusion  or  herniation.    A 
neurosurgical  evaluation  performed  on  27  February  2001,  7  months  before  separation, 
recorded “good ROM in flexion and extension,” and normal gait.  The neurosurgeon noted the 
MRI  showed  no  disc  herniation  and  recommended  non‐surgical  treatment.    The  CI  declined 

imaging  (MRI)  of  the 

Condition 

Chronic low back pain 

Code 

5299‐5295 

Rating
10%

↓No Addi(cid:415)onal MEB/PEB Entries↓  

Combined:  10% 

Condition
Disc disease low back
Headaches
Pes planus, bilateral

Code 

5293‐5292 

8100 
5276 

Rating 
40% 
30% 
10% 

Exam

20021025
20021025
20021025

0% X 4 / Not Service‐Connected x 1 

Combined:  60% 

injections  offered  by  a  pain  specialist.    At  the  MEB  examination,  3  May  2001,  the  CI's  back 
range‐of‐motion (ROM) was limited by pain to 90 degrees of forward flexion, extension zero 
degrees.    The  CI  stated  he  was  unable  to  extend  the  back  beyond  normal  anatomic  plane 
stating  that  hyperextension  increased  his  back  pain.    Lateral  movements  were  5  degrees 
bilaterally.  He also stated that rotation of the lumbar spine worsened his pain.  There was pain 
reported with a maneuver not expected to cause pain.  Straight leg raising (SLR) was negative 
for nerve root irritation (he had pain in lower back with no radiation).  Strength and sensation 
were normal.  Both his heel and toe walking were normal without mention of antalgia.  At the 
VA Compensation and Pension (C&P) exam on 25 October 2002, the CI underwent a general 
medical examination and a neurology assessment.  At the general examination, the CI claimed 
tenderness to any percussion of the back and declined to participate in the ROM examination 
stating  “something  I  can’t  do.”    The  CI  also  declined  to  cooperate  with  the  knee  ROM 
examination  “Because  it  hurts  if  I  do.”    Gait  was  slow.    During  the  separate  neurology  C&P 
examination  on  25  October  2002,  gait  was  normal  with  good  tandem  gait.    There  was 
percussion  tenderness  over  the  lumbar  spine.    ROM  of  the  lumbar  spine  was  30  degrees  of 
flexion, 5 degrees of extension, and 15 degrees of right and left lateral flexion, all with pain.  
Strength was normal (5/5) in all muscle groups bilaterally although there was some give‐way 
weakness in the lower extremities secondary to back pain.  Deep tendon reflexes and sensation 
were intact.  Lumbar spine X‐rays 25 October 2002 were normal including normal intervertebral 
disc spaces. 
 
The  Board  directs  attention  to  its  rating  recommendation  based  on  the  above  evidence.    In 
accordance with DoDI 6040.44, the Board is required to recommend a rating IAW the VASRD in 
effect  at  the  time  of  separation.    The  Board  notes  that  the  2001  Veteran  Administration 
Schedule  for  Rating  Disabilities  (VASRD)  standards  for  the  spine,  which  were  in  effect  at  the 
time of separation, were changed to the current §4.71a rating standards in 2004.  The Board 
must  correlate  the  above  clinical  data  with  the  2001  rating  schedule  (applicable  diagnostic 
codes include: 5292 limitation of lumbar spine motion; 5293 intervertebral disc syndrome; and 
5295  Lumbosacral  strain).    The  PEB  rated  the  condition  10%  citing  “characteristic  pain  on 
motion, coded 5299‐5295 (lumbosacral strain).  The VA rated 40% citing limitation of motion at 
the time of the C&P examinations over a year after separation (coded 5293‐5292).  The Board 
considered the rating under the VASRD diagnostic code 5292 in effect at the time.  The Board 
agreed  that  with  the  ROM  at  the  time  of  the  neurology  examination  7  months  before 
separation and  the  MEB  examination  4  months  before  separation,  supported  the  10%  rating 
but not a higher rating under code 5292.  The Board noted the VA examinations over a year 
after separation showing moderate to severe limitation of motion without apparent cause for 
the marked reduction since the MEB examination.  The neurology examination demonstrated 
an otherwise normal examination including gait.  X‐rays  of the lumbar spine obtained at the 
time of the C&P examination were normal.  The Board concluded the MEB examination which 
was more proximate to the time of separation, was more reflective of the disability at the time 
of separation.  The Board then considered whether a higher rating was warranted under codes 
5293 or 5295 of the VASRD in effect at date of separation.  Magnetic resonance imaging (MRI) 
prior to separation did not demonstrate evidence of intervertebral disc disease and there was 
no  evidence  of  sciatic  neuropathy  or  radiculopathy  to  warrant  consideration  under  the  5293 
intervertebral disc syndrome code.  All members agreed the MEB examination also supported a 
10%  rating  under  the  5295  code,  lumbosacral  stain,  characteristic  pain  on  motion  but  not  a 
higher rating.  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 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 

   2                                                           PD12‐00857 

 

inconsistent  with  the  VASRD  in  effect  at  the  time  of  the  adjudication.    In  the  matter  of  the 
chronic LBP 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, as follows:   
 

VASRD CODE  RATING
5299‐5295 
COMBINED 

10%
10%

Chronic low back pain 

UNFITTING CONDITION

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120606, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

           XXXXXXXXXXXXXXXX, DAF 
           President 
           Physical Disability Board of Review 

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, AR20130001175 (PD201200857) 

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: 

 

 
 

 

 
 

 

 
 
 
 

   3                                                           PD12‐00857 

 

 

 

 

Encl 

 

 

 

 

 

 

 

 

 

 

 

 

     XXXXXXXXXXXX 

     Deputy Assistant Secretary 
         (Army Review Boards) 

 

 

 

 
CF:  

(  ) DoD PDBR 

(  ) DVA 

 

   4                                                           PD12‐00857 

 



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