RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE: ARMY 
SEPARATION DATE:  20020622 

 
NAME: XXXXXXXXXXXXXXXX  
CASE NUMBER:  PD1201058 
BOARD DATE:  20130123 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  Soldier,  SPC/E-4,  (92A/Automated  Logistical 
Specialist), medically separated for chronic low back pain (LBP) with lumbar degenerative disk 
disc  disease  (DDD).  The  CI  did  not  improve  adequately  with  treatment  to  meet  the  physical 
requirements of her Military Occupational Specialty (MOS) or satisfy physical fitness standards.  
She was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB).  The 
MEB  forwarded  lumbar  DDD  with  LBP  as  medically  unacceptable  IAW  AR  40-501.    The  MEB 
forwarded  no  other  conditions  for  Physical  Evaluation  Board  (PEB)  adjudication.    The  PEB 
adjudicated  chronic  LBP  with  lumbar  DDD  as  unfitting,  rated  10%,  with  application  of  the 
Veteran’s  Affairs  Schedule  for  Rating  Disabilities  (VASRD)  and  the  Department  of  Defense 
Instruction (DoDI) 1332.39.  The CI made no appeals, and was medically separated with a 10% 
disability rating. 
 
 
CI CONTENTION: The CI wrote: “Army rated/VA rated 50% day after discharge.” 
 
 
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 remaining conditions rated by the VA 
at  separation  and  listed  on  the  DD  Form  294  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  Army  Board  for 
Correction of Military Records. 
 
 
RATING COMPARISON:   
 

Service PEB – Dated 20020311 

VA (2 Mos. Pre-Separation) – All Effective Date 20020623 

Condition 

Chronic LBP, w/Lumbar 
DDD 

Code 

5299-5295 

Rating 
10% 

↓No Additional MEB/PEB Entries↓ 

Condition 

DDD, L-Spine, L4-5, L5-S1 with 
Herniated Nucleus Pulposus 
Postoperative Residuals, Carpal 
Tunnel Syndrome Release, R 
Wrist (Dominant) 
Carpal Tunnel Syndrome, L Wrist 
(Non-Dominant) w/L Pronator 
Teres Syndrome 
Plantar Fasciitis, R Foot 
Patellofemoral Pain  Syndrome, 
R Knee 
Patellofemoral Pain Syndrome, L 
Knee 

Code 
5293 

Rating 
10% 

Exam 

20020417 

8599-8515 

10% 

20020417 

8599-8515 

5276 
5024 

5024 

10% 

10% 
10% 

10% 

20020417 

20020417 
20020417 

20020417 

0% X 2 / Not Service-Connected x 1 

Combined: 50% 

20020417 

Combined:  10% 

 
 
ANALYSIS SUMMARY: 
 
Chronic  Low  Back  Pain.    The  2002  Veteran  Administration  Schedule  for  Rating  Disabilities 
(VASRD) coding and rating standards for the spine were in effect at the time of separation.  IAW 
DoDI 6040.44, this Board must consider the appropriate rating for the CI’s back  condition at 
separation based on the VASRD standards in effect at that time.  The condition began during 
basic training in 1997 after falling while running.  X-rays were normal, but a magnetic resonance 
imaging  (MRI)  demonstrated  multi-level  DDD  with  small  disc  herniations  at  L4-5  and  L5-S1 
causing  mild to  moderate  spinal  stenosis  at these  levels.    Ongoing  physical  therapy  (PT)  and 
epidural steroid injections (ESI) were not helpful.  A lumbar discogram in June 2001 reproduced 
LBP,  and  surgery  was  considered  but  not  performed.    The  narrative  summary  (NARSUM) 
examiner on 18 September 2001 (9 months prior to separation) indicated that intermittent mild 
sciatic  pain  occurred.    She  could  not  tolerate  high  impact  activity.    Examination  revealed  a 
normal gait and “full range of lumbar motion.”  Mild tenderness of the low lumbar spine was 
present.    Muscle  strength,  sensation  and  deep  tendon  reflexes  (DTR)  were  normal.    An 
outpatient examination on 21 November 2001 (7 months prior to separation) documented a 
negative  straight  leg  raise  (SLR)  test  and  normal  muscle  strength,  sensation  and  DTRs.    An 
undated  outpatient  note  in  2002  indicated  that  LBP  was  constant  and  radiated  up  the  back.  
There were no lower extremity sensory disturbances.  Examination revealed a normal gait, no 
tenderness  and  a  negative  SLR.    A  back  brace  was  recommended  for  work.    At  the  VA 
Compensation and Pension (C&P) exam on 17 April 2002 (2 months prior to separation), the CI 
reported  constant  LBP  that  was  aggravated  by  normal  daily  activity.    She  used  narcotic 
medication for pain.  Examination revealed a normal posture and gait.  Range-of-motion (ROM) 
assessment  showed  flexion  of  90  degrees  (normal  is  90  degrees  by  current  standards), 
extension 30 degrees (normal 30 degrees), lateral flexion 35 degrees each (30 degrees normal) 
and  rotation  30  degrees  (30  degrees  normal).    Pain  was  present  during  flexion,  right  lateral 
flexion and right rotation.  SLR testing was negative for radiating pain.  DTRs and sensation were 
intact.  At a later C&P exam on 23 June 2003 (a year after separation), the CI reported constant 
low back dull, aching pain.  While walking, standing, squatting or bending over she experienced 
intermittent shooting pain to the legs that lasted a few seconds.  She sometimes used a back 
brace.  Her back condition made sleep difficult.  Her condition did not result in missed work as a 
correctional officer that entailed 12 hour shifts.  There were no incapacitating episodes during 
the  preceding  year.    Examination  revealed  normal  posture  and  gait.    Lumbar  flexion  was  70 
degrees,  extension  55  degrees,  flexion  40  degrees  bilaterally  and  rotation  35  degrees 
bilaterally.  There was no spasm or tenderness.  Neurologic exam of the lower extremities was 
normal. 
 
The  Board  must  correlate  the  above  clinical  data  with  the  2001  rating  schedule  which,  for 
convenience, is excerpted below: 
 

5292 Spine, limitation of motion of, lumbar: 

Severe ………………………………………………………..……….…………..... 40 
Moderate …………………………………….……………….…….…………..... 20 
Slight ………………………………………………………..……………………..….10 

 
 
 

 
 
 
 
 
 
 
5293 Intervertebral disc syndrome: 

   Pronounced; with persistent symptoms compatible 
   with sciatic neuropathy with characteristic 
   pain and demonstrable muscle spasm, absent 
   ankle jerk, or other neurological findings appropriate 
   to site of diseased disc, little intermittent 
   relief ....................................................................................... 60 
   Severe; recurring attacks, with intermittent relief…………….... 40 
   Moderate; recurring attacks ................................................... 20 
   Mild ......................................................................................... 10 
   Postoperative, cured ................................................................. 0 

 
5295 Lumbosacral strain: 

Severe; with listing of whole' spine to opposite side, positive 

Goldthwaite's sign, marked limitation of forward bending in 
 standing position, loss of lateral motion with osteo-arthritic 
 changes, or narrowing or irregularity of joint space, or some 
 of the above with abnormal mobility on forced motion ……... 40 

With muscle spasm on extreme forward bending, loss of lateral spine  

 motion, unilateral, in standing' position ……………...………...….. 20 
With characteristic pain on motion ………………………………..……...…. 10 
With slight subjective symptoms only ……………………...…………...……. 0 

 
The PEB cited “characteristic pain on motion” in support of the 10% rating under an analogous 
5295 code, while the VA also arrived at a 10% rating under the 5293 code for “mild” symptoms 
associated  with  intervertebral  disc  syndrome.    The  Board  agreed  that  elements  of  the  20% 
rating under these codes were not present on any of the cited examinations.  Board members 
debated if any of the documented examinations met the requirements for the 20% level under 
the 5292 code, but agreed that ROM limitation in evidence was no more than “slight.”  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 chronic 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 1332.39 for rating chronic LBP was operant in this case and the condition was 
adjudicated independently of that instruction by the Board.  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% 

           XXXXXXXXXXXXXXXXXXXX, DAF 
           Acting Director 
           Physical Disability Board of Review 

Chronic Low Back Pain with Lumbar Degenerative Disc Disease 

UNFITTING CONDITION 

 
 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120615, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

 
 
 

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 XXXXXXXXXXXXXXXXX, AR20130003781 (PD201201058) 
 
 
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 
 
 
 

     XXXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)