RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  ARMY 
SEPARATION DATE:  20021117 

 
NAME:  XXXXXXXXXXXXXXXXXX 
CASE NUMBER:  PD1201181 
BOARD DATE:  20130111 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  PFC/E-3  (92A10/Automated  Logistical  Specialist), 
medically separated for chronic mechanical low back pain (LBP).  The condition began in basic 
training  in  September  2000.    He  was  treated  with  anti-inflammatory  pain  medications  and 
activity modifications; there was no surgical indication.  During the course of his evaluation, a 
previously  asymptomatic,  stable  thoracolumbar  scoliosis  was  discovered.    The  CI  did  not 
improve  adequately  with  rehabilitative  treatment  to  meet  the  physical  requirements  of  his 
Military Occupational Specialty (MOS).  He was issued a permanent L3 profile and referred for a 
Medical  Evaluation  Board  (MEB).    Stable  thoracolumbar  scoliosis  with  mechanical  LBP  was 
forwarded to the  Physical  Evaluation  Board  (PEB)  as  medically  unacceptable  IAW  AR 40-501.  
No  other  conditions  appeared  on  the  MEB’s  submission.    The  PEB  adjudicated  the  chronic 
mechanical  LBP  condition  as  unfitting,  rated  10%  with  application  of  the  Department  of 
Defense Instruction (DoDI) 1332.39.  The CI made no appeals, and was medically separated with 
a 10% disability rating. 
 
 
CI CONTENTION:  “I have two separate diagnoses while in the service and the Army decided to 
render me unfit for the less serious one.  I received a disability rating for one condition however 
I was diagnosed for another condition which the Army overlooked.  The additional diagnosis is 
documented in my file.  I was separated as a result of scoliosis but one of the doctors diagnosed 
me with a “crack” in my spine but the Army overlooked it.  I have since moved and lost my VA 
determination letter.” 
 
 
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 
  The  chronic  mechanical  LBP, 
thoracolumbar scoliosis and “cracked spine” conditions requested for consideration meet the 
criteria prescribed in DoDI 6040.44 for Board purview, and are accordingly addressed below.  
Any condition 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. 
 
 
RATING COMPARISON:   
 

in  all  cases. 

VA (<1 Month Pre-Separation) – All Effective Date 20021118 

Service IPEB – Dated 20020903 
Condition 

Code 

Rating 

Chronic Mechanical Low 
Back Pain 

5299-5295 

10% 

No Additional MEB/PEB Entries 

Combined:  10% 

 

Condition 

Chronic Lumbosacral Strain 
Spondylolysis, L5 
Thoracolumbar Scolisis, Stable 

Code 
5295 

5299-5294 
5299-5291 

Rating 
20% 
NSC 
NSC 

Exam 

20021022 
20021022 
20021022 
20021022 

0% X 1 

Combined:  20% 

ANALYSIS SUMMARY: 
 
Low  Back  Pain  Condition.    The  2003  Veteran  Administration  Schedule  for  Rating  Disabilities 
(VASRD)  coding  and  rating  standards  for  the  spine,  which  were  in  effect  at  the  time  of 
permanent separation, were changed to the current §4.71a rating standards on 26 September 
2003, following the CI’s permanent disability disposition.  The older ratings were based on a 
judgment as to whether the disability was mild, moderate or severe.  The current standards are 
grounded  in  range-of-motion  (ROM)  measurements.    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 the time of separation.  The first relevant clinical note (16 October 2000) 
stated that back pain was present for 3 weeks and was not associated with a history of trauma.  
A  radiographic  evaluation  in  September  2001  suggested  the  possibility  of  L5  spondylosis  (a 
stress fracture or “crack”), however follow-up X-rays and a bone scan were negative for this 
condition.    X-rays  confirmed  the  presence  of  scoliosis.    The  narrative  summary  (NARSUM) 
examiner 5 months prior to separation indicated the condition began after falling down stairs 
during basic training.  The LBP was daily and was exacerbated by load bearing activity, running, 
push-ups and sit-ups.  Pain medication was occasionally helpful.  There was no leg pain and a 
back  brace  was  not  used.    Physical  examination  revealed  a  normal  gait.    A  mild  thoracic 
prominence  on  forward  bending  was  present.    There  was  mild  superficial  paraspinous  and 
midline tenderness, but no spasm.  Forward flexion was “limited.”  Straight leg testing (SLR) was 
negative.    Muscle  strength,  sensation  and  deep  tendon  reflexes  (DTR)  were  normal.    The 
examiner’s assessment was that scoliosis was idiopathic, likely pre-existed entry into the service 
and may have predisposed to the development of LBP.  At the VA Compensation and Pension 
(C&P) exam a month prior to separation, the CI reported daily and constant LBP that waxed and 
waned throughout the day.  Bending, weight lifting or load-bearing activities caused the most 
pain.  No back supports were used.  There were no symptoms of radiculopathy.  Examination 
revealed  a  normal  gait  and  a  mild  rightward  thoracolumbar  curvature.    Tenderness  of  the 
bilateral thoracolumbar paraspinal muscles was present.  Lower extremity strength was normal 
and  SLR  was  negative.    ROM  measurements  revealed  flexion  of  50  degrees  (normal  to  90 
degrees  by  current  standards),  extension  of  30  degrees  (normal  30  degrees)  and  bilateral 
flexion of 30 degrees (normal 30 degrees).  Painful motion, fatigability and increased pain with 
repetitive use were present. 
 
The Board must correlate the above clinical data with the 24 September 2002 rating schedule 
which, for convenience, is excerpted below: 

 
5292 Spine, limitation of motion of, lumbar: 

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

 

  
  
  

 

 
 
 

 
 
 

 
5294 Sacro-iliac injury and weakness: 
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 and VA assigned 10% and 20% ratings respectively under the 5295 code (analogously 
by the PEB).  Board members agreed that criteria supporting a rating higher than 10% under 
this  code  were  not  in  evidence,  but  debated  if  a  higher  rating  is  supported  under  the  5292 

2                                                           PD1201181 
 

code.  The VA examiner noted lumbar flexion of 50 degrees, which supports a 20% rating under 
current VASRD ROM standards.  The NARSUM examiner also noted “limited” flexion, although 
measured ROM was not specified.  The Board majority agreed that the ROM in evidence most 
closely approximated “moderate” under this code, and thus justified a 20% rating.  The Board 
also  considered  whether  a  higher  rating  could  be  achieved  under  the  formula  for  rating 
intervertebral  disc  disease  based  on  incapacitating  episodes;  however,  the  minimum  rating 
under  that  formula  was  not  met.    Finally  the  Board  noted  that  the  presence  of  a  “crack” 
(spondylolysis)  was  not  confirmed  by  specialized  testing;  however,  even  if  the  condition’s 
existence was conceded, a separate rating could not be assigned under VASRD §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  20%  for  the  chronic  mechanical  LBP  condition, 
coded 5292. 
 
 
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 mechanical LBP was operant in this case and the 
condition was adjudicated independently of that instruction by the Board.  In the matter of the 
chronic mechanical LBP condition, the Board, by a vote of 2:1, recommends a disability rating of 
20%,  coded  5292  IAW  VASRD  §4.71a.    The  single  voter  for  dissent  (who  recommended  no 
change  in  the  PEB  adjudication)  did  not  elect  to  submit  a  minority  opinion.    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 

5292 

COMBINED 

20% 
20% 

Chronic Mechanical Low Back Pain 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120607, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXXXXXXX, DAF 
           Acting Director 
           Physical Disability Board of Review 

3                                                           PD1201181 
 

 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / XXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for XXXXXXXXXXXXXXXXXX, AR20130003051 (PD201201181) 
 
 
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 rating to 20% 
without 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 
 
 
 

     XXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards) 

 
 
 

 
 
 

 
 
 

 
 
 

 
 
 

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