RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXXXXXXXXXXXXXX                                                                     BRANCH OF SERVICE:  ARMY 
CASE NUMBER:  PD1201159                                                                   SEPARATION DATE:  20031113 
BOARD DATE:  20120118 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  SGT/E-5  (92A/Automated  Logistical  Specialist) 
medically  separated  for  a  lumbar  spine  condition.    He  injured  his  back  in  1999  and  was 
eventually diagnosed with degenerative disc disease (DDD).  The condition worsened with time 
and did not improve adequately with conservative measures to meet the requirements of his 
Military  Occupational  Specialty  (MOS)  or  satisfy  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  Physical  Evaluation  Board  (PEB)  IAW  AR  40-501.    No  other  conditions 
were submitted by the MEB.  The PEB adjudicated the lumbar spine condition as unfitting, rated 
10%, citing criteria of the Veterans Administration Schedule for Rating Disabilities (VASRD).  The 
CI made no appeals, and was medically separated with a 10% disability rating. 
 
 
CI CONTENTION:  “Buldge [sic] disc in Lower back, I’m doing what I can driving 18 wheelers for a 
living  and  always  in  constant  pain;  numbness  and  tingling.    Driving  18  wheelers  for  Postal 
Service I’m constantly bouncing around and up and down truck steps all day.”   
 
 
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 service and those conditions identified but not determined to be unfitting by 
the  PEB  when  specifically  requested  by  the  CI.    The  rating  for  the  unfitting  lumbar  spine 
condition is addressed below.  No additional conditions are within the DoDI 6040.44 defined 
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 service Board for Correction of Military Records.  The Board further acknowledges the 
CI’s  information  regarding  the  significant  impairment  with  which  his  service-connected 
condition continues to burden him but must emphasize that the Disability Evaluation System 
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  Veteran  Affairs,  operating  under  a 
different set of laws.   
 
 
RATING COMPARISON:   
 

Service IPEB – Dated 20030808 
Code 

Condition 

Back Pain...Degenerative Changes 

5299-5295 

No Additional MEB/PEB Entries 

Combined:  10% 

VA (2 Mo. Post-Separation) - VARD Dated 20040415 

Rating 
10% 

Condition 

Lumbar DDD w/o Radiculopathy 

Code 
5242 

Rating 
20% 

Not Service Connected x 7 

Combined:  20% 

Exam 

20040120  
20040120 

ANALYSIS SUMMARY: 
 
Lumbar Spine Condition.  The CI first developed back pain in April 1999 while running with a 
loaded  pack.    The  pain  was  intermittent  and  related  to  more  strenuous  activity  initially,  but 
evolved into a constant complaint with intermittent radiation down the left leg.  Initial imaging 
suggested DDD at the L4/5 level, and he was referred to orthopedics.  He was managed over an 
extended period with physical therapy (PT), medication and temporary profile.  By 2002, the 
pain and limitations were significant and imaging confirmed a mild bulging disc at L4/5.  Also 
noted  were  findings  (sacralization  and  pseudoarthrosis  at  L5/SI)  consistent  with  a  congenital 
condition (Bertolotti Syndrome).  Although there was radicular pain in a left L4/5 pattern, there 
were  no  sensory  or  motor  deficits.    Neurosurgery  did  not  recommend  surgical  intervention.  
Continued  PT  and  a  trial  of  epidural  injections  were  unsuccessful  in  restoring  adequate 
function,  and  a  MEB  was  initiated.    The  narrative  summary  (NARSUM)  noted  constant  pain 
rated 4/10,  with  exacerbations  to 10/10  with “prolonged  standing,  running  or heavy  lifting.”  
The  CI  was  quoted  as  relaying  that,  “Any  little  thing  that  puts  stress  on  my  back  brings  me 
extreme pain.  I can simply do almost nothing without causing pain.  Treatments have provided 
no  relief.”    The physical  exam  recorded  the absence  of deformity or  spasm,  the presence  of 
paravertebral  tenderness,  and  normal  motor/sensory/reflex  findings.    The  range-of-motion 
(ROM)  measurements  recorded  in  the  NARSUM  were  a  flexion  of  80  degrees  (normal  90 
degrees) and a combined ROM of 210 degrees (normal 240 degrees).  A MEB outpatient note (9 
months prior to separation) documents a severely limited flexion of 10 degrees; but, this is not 
corroborated by any other contemporary entries.  A PT note 3 months prior to separation (after 
the NARSUM measurements) documents normal flexion, “fingers to feet with no complaints of 
low back pain,” a 50% reduction in left lateral flexion, and normal ROM in remaining planes.  At 
the  VA  Compensation  and Pension  (C&P)  exam  performed 2  months  after  separation,  the  CI 
reported constant pain at the same ratings noted in the NARSUM with similar limitations (e.g., 
pain after 1/2 block of walking, inability to tie shoes, etc.).  The VA physical exam noted the 
absence  of  spasm  and  normal  neurologic  findings.    The  VA  examiner  expressed  ROM 
measurements  for  the  lumbar  segment  only,  noting  30⁰  flexion  (normal  40⁰)  with  moderate 
decreases in all planes, “limited by pain and stiffness.”  The examiner stated, “I interpret his 
back pain to be due to disc disease and muscle spasm rather than to nerve root compression.”   
 
The Board directs attention to its rating recommendation based on the above evidence.  It must 
be  noted  that  in  the  interim  between  the  PEB  adjudication  and  the  date  of  separation  the 
VASRD codes and rating criteria for the spine underwent a significant transition.  The VASRD 
§4.71a general rating formula for the spine, currently in effect and for the VA rating decision, 
became  effective  25  August  2003;  IAW  DoDI  6040.44, the  Board’s  recommendation  must be 
premised on the VASRD in effect at the time of separation.  The PEB’s 10% rating under the 
older code 5295 (lumbosacral strain) was supported by the criteria of that code, and the criteria 
for a higher rating under that or any other code in effect were not in evidence.  The VA rating 
under 5242 (degenerative arthritis of the spine), although defaulting to the applicable VASRD 
criteria, is difficult to reconcile with ROM measurements confined to the lumbar segment (with 
rating  criteria  premised  on  full  thoracolumbar  ROM).    Citing  the  examiner’s  30  degrees 
(segmental  lumbar)  flexion,  which  would  yield  a  40%  rating  under  the  full  thoracolumbar 
criteria in effect, the rating decision assigned a 20% rating determination.  Since 30 degrees is a 
25% reduction in normal lumbar segmental flexion, mathematical extrapolation to the ratable 
range  (an imprecise  speculation)  would  yield  >65  degrees,  still  within  the  10%  rating  criteria 
range  for  the  standards  in  effect.    Board  members  furthermore  agreed  that  the  segmental 
measurements were a significant probative value concern for the VA ROM evidence in general.  
Both the NARSUM ROMs and the subsequent PT ROMs clearly support a 10% rating under the 

standards in effect at separation; and, the NARSUM ROM evaluation is the only one in evidence 
which is compliant with VASRD §4.46 (accurate measurement).  Board members also agreed 
that  the  earlier  PT  note  documenting  a  flexion  of  10  degrees  was  too  atypical  and 
uncorroborated to carry significant probative value.   
 
The  Board  additionally  considered  if  the  residual  L4/5  radiculopathy  (unrated  by  the  VA) 
warranted  additional  disability  rating;  but,  members  agreed  that  the  requisite  link  of  the 
neuropathy  with  unfitting  impairment  was  not  in  evidence.    The  pain  component  of  a 
radiculopathy  is  subsumed  under  the  general  spine  rating  as  specified  in  §4.71a.    After  due 
deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the 
Board recommends a disability rating of 10% for the lumbar spine condition complying with the 
applicable VASRD criteria.  The action officer agrees with the 5242 coding choice applied by the 
VA, and the members concurred. 
  
 
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  lumbar  spine  condition,  the  Board  unanimously 
recommends a disability rating of 10%, coded 5242, IAW VASRD §4.71a in effect at separation.  
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 

5242 

COMBINED 

10% 
10% 

Lumbar Degenerative Disc Disease  

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120610, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXXX, DAF 
           Acting Director 
           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 XXXXXXXXXXXXXXXXX, AR20130003116 (PD201201159) 
 
 
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 
 
 
 

     XXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)