SEPARATION DATE:  20030110 

 
NAME: XXXXXXXXXXXX                                                                      BRANCH OF SERVICE:  ARMY  
CASE NUMBER:  PD1201084 
BOARD DATE:  20121106 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty SGT/E-5 (92Y/Supply Specialist), medically separated 
for mechanical low back pain.  The CI developed hip and low back pain in 2001.  She could not 
be  adequately  rehabilitated  to  meet  the  physical  requirements  of  her  Military  Occupational 
Specialty  or  satisfy  physical  fitness  standards.    She  was  issued  a  permanent  L3  profile  and 
referred for a Medical Evaluation Board (MEB).  Mechanical low back pain and myofascial pain 
of  the  right  hip  were  forwarded  to  the  Physical  Evaluation  Board  (PEB)  as  medically 
unacceptable  IAW  AR  40-501.    Three  other  conditions  (identified  in  the  rating  chart  below) 
were  addressed  by  the  MEB,  and  forwarded  as  meeting  retention  standards.    The  PEB 
adjudicated the mechanical low back pain condition as unfitting, rated 10%, citing criteria of the 
Veterans Administration Schedule for Rating Disabilities (VASRD).  The myofascial pain of the 
right hip condition and the remaining conditions were determined to be not unfitting.  The CI 
made no appeals, and was medically separated with a 10% disability rating. 
 
 
CI CONTENTION:  “I have several ratings of 0% 10% and 20%.  During and through the years my 
conditions  have  become  worse.”    The  CI  attached  a  one  page  statement  to  her  application 
which was reviewed and considered by the Board.   
 
 
SCOPE  OF  REVIEW:    The  Board  wishes  to  clarify  that  the  scope  of  its  review  as  defined  in 
Department of Defense Instruction (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 rating for the unfitting mechanical low back pain 
condition 
in  request  for  Board 
consideration,  or  any  condition  or  contention  outside  the  Board’s  defined  scope  of  review, 
remain eligible for future consideration by the Army Board for Correction of Military Records. 
 

is  addressed  below. 

  Any  other  conditions 

intended 

RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

Service PEB – Dated 20021125  

VA (1 Mos. Post-Separation) – All Effective Date 20030111 

RATING COMPARISON: 
 

Condition 

Mechanical Low Back Pain 
Myofascial Pain Right Hip 
Recurrent Plantar Fasciitis 
Intermittent Shoulder 
Pain 
Recur  Tinea Versicolor 

Rating 
10% 

Code 
5295 
Not Unfitting 
Not Unfitting 
Not Unfitting 
Not Unfitting 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

Condition 

Code 

NSC 

5294-5295 
5299-5252 

SI Dys.. w/ Chr.  Low Back Pain 
Left Hip Sprain 
Right Hip Pain 
Bilateral Plantar Fasciitis 
Right Shoulder Sprain 
Left Shoulder Sprain 
Tinea Versicolor 
Cervical Spine Sprain 
Left Knee Retropatellar  Syn  
Right Knee Retropatellar Syn 
Right Elbow Tenosynovitis 

5299-5201 
5299-5201 
7813-7806 
5299-5290 
5260-5014 
5260-5014 
5206-5024 
0% X 2 / Not Service-Connected x 3 

5276 

Combined:  50% 

Rating 
10% 
0% 

0% 
0% 
0% 
0% 
20% 
10% 
10% 
10% 

Exam 

20030221 
20030221 
20030221 
20030221 
20030221 
20030221 
20030221 
20030221 
20030221 
20030221 
20030221 
20030221 

 
 
 
ANALYSIS SUMMARY:  The Disability Evaluation System (DES) is responsible for maintaining a fit 
and  vital  fighting  force.  While  the  DES  considers  all  of  the  member's  medical  conditions, 
compensation  can  only  be  offered  for  those  medical  conditions  that  cut  short  a  member’s 
career, and then only to the degree of severity present at the time of final disposition.  The DES 
has neither the role nor the authority to compensate members for anticipated future severity 
or  potential  complications  of  conditions  resulting  in  medical  separation  nor  for  conditions 
determined  to  be  service-connected  by  the  Department  of  Veteran  Affairs  (DVA)  but  not 
determined to be unfitting by the PEB.  However the DVA, operating under a different set of 
laws  (Title  38,  United  States  Code),  is  empowered  to  compensate  all  service-connected 
conditions  and  to  periodically  re-evaluate  said  conditions  for  the  purpose  of  adjusting  the 
Veteran’s disability rating should the degree of impairment vary over time.  The Board’s role is 
confined to the review of medical records and all evidence at hand to assess the fairness of PEB 
rating  determinations,  compared  to  VASRD  standards,  based  on  severity  at  the  time  of 
separation.  
 
Mechanical Low Back Pain Condition. The CI developed pain in right hip and low back in 2001 
during  routine  military  duties.    X-rays  of  the  lumbar  spine  were  normal.    Treatment  with 
physical  therapy  and  medication  resulted  in  unsustained  improvement.    There  were  two 
goniometric range-of-motion (ROM) evaluation in evidence, with documentation of additional 
ratable  criteria,  which  the  Board  weighed  in  arriving  at  its  rating  recommendation;  as 
summarized in the chart below. 

Thoracolumbar ROM 

(Degrees) 

Flexion (90 Normal) 

Extension (30) 
Combined (240) 

Comment 

§4.71a Rating 

 

  

Ortho Consult  
~5 Mo. Pre-Sep 

(20020806) 

80 
20 
 NA 

MEB ~ 2 Mo. Pre-Sep 

(20021107) 

90 
15 
230 

 Motor,sensory,reflexes  wnl;  No 
pain  recorded;  SLR  without  pain; 
all ROM without difficulty 

 Tenderness  over 
sacrum 
motor/sensory/reflexes  wnl; 
no spasm  

10% 

10% 

On orthopedic evaluation performed on 6 August 2002, the CI reported back pain with running, 
jumping,  sit-ups  and  wearing  rucksack  and  individual  battle  armor  (IBA).    She  reported 
intermittent numbness and tingling down the lateral back of her right leg but not present at 
time of this exam.  Findings on this examination are contained above.  At the MEB/narrative 
summary  (NARSUM)  exam,  performed  on  7  November  2002,  the  CI  reported  pain  and  leg 
numbness  aggravated  by  repeated  bending,  lifting  walking  or  standing  for  more  than  15 
minutes  or  sitting  greater  than  20  minutes.    Findings  on  physical  examination  are  reported 
above.  The VA Compensation and Pension (C&P) evaluation performed on 21 February 2003, a 
month after separation, utilized the MEB examination in its assessment of the back condition.  
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and VA both rated the back condition 10% code 5295, lumbosacral strain.  A higher rating 
of 20% under this code requires muscle spasm on extreme forward bending with loss of lateral 
spine  motion,  not  supported  by  the  record  in  evidence.    The  2003  VASRD  coding  and  rating 
standards for the spine, which were in effect at the time of separation, were changed to the 
current  §4.71a  rating  standards  on  27  September  2003.    The  2003  VASRD  based  on  ROM 
impairment  were  subject  to  the  rater’s  opinion  regarding  degree  of  severity,  whereas  the 
current standards specify rating thresholds in degrees of ROM impairment.  When older cases 
have goniometric measurements in evidence, the Board reconciles (to the extent possible) its 
opinion regarding degree of severity for the older spine codes and ratings with the objective 
thresholds  specified  in  the  current  VASRD  §4.71a  general  rating  formula  for  the  spine.    This 
promotes  uniformity  of  its  recommendations  for  different  cases  from  the  same  period  and 
more  conformity  across  dates  of  separation,  without  sacrificing  compliance  with  the  DoDI 
6040.44 requirement for rating IAW the VASRD in effect at the time of separation.  The Board 
unanimously agreed with the 10% rating for the back condition at separation and noted that 

 

this decision was consistent with subsequent VASRD §4.71 standards as discussed above.  There 

was no evidence of ratable peripheral nerve impairment in this case since no motor weakness 
was  present,  and  the  sensory  component  had  no  functional  implications.    There  was  no 
evidence of intervertebral disc syndrome with incapacitating episodes for higher rating under 
the 5293 code.  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 low back pain 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.    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  mechanical  low  back  pain  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:   
 

UNFITTING CONDITION 

VASRD CODE  RATING 

5295 

COMBINED 

10% 
10% 

Mechanical Low Back Pain 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120706, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 

 

           XXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

 
 

 
 
 

 
 
 

 
 
 

 
 
 

 
 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB /  ), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXXXX, AR20120021214 (PD201201084) 
 
 
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 
 
 
 
CF:  
(  ) DoD PDBR 
(  ) DVA 
 
 

     XXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)