RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

BRANCH OF SERVICE:  NAVY  
SEPARATION DATE:  20030326 

 
NAME:  X 
CASE NUMBER:  PD1201481 
BOARD DATE:  20130314 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty AN/E-3 (Airman) medically separated for a weakness 
of  extremities.    The  CI  was  hospitalized  in  December  2001  for  progressive  weakness  of  the 
lower  extremities.    Despite  treatment,  the  CI  could  not  be  rehabilitated  to  meet  the 
requirements of his rating or physical fitness standards.  He was placed on limited duty (LIMDU) 
and  referred  for  a  Medical  Evaluation  Board  (MEB).    The  MEB  sent  three  diagnoses  to  the 
Physical  Evaluation  Board  (PEB):  “History  of  Guillain-Barre  syndrome”  (Primary);  “History  of 
protracted  weakness  of  both  upper  and  lower  extremities  after  Guillain-Barre  syndrome, 
improving” (Second); and, “History of chronic lumbago” (Third).  The PEB adjudicated “History 
of protracted weakness of both upper and lower extremities after Guillain-Barre syndrome” as 
Category I (unfitting) and rated 10%.  The diagnosis of “History of Guillain-Barre syndrome” was 
judged  as  Category  II  (contributing)  while  “History  of  chronic  lumbago”  and  “Chronic 
lumbosacral strain, posttraumatic” were deemed Category III (not contributing, not unfitting).  
The CI made no appeals and was medically separated with a 10% service disability rating. 
 
 
CI CONTENTION: The application states “Guillain-Barre syndrome with lumbosacral strain was 
change without my permission.  I am attaching the original rating letter I receive from the VA.” 
 
 
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 weakness of both upper and lower extremities, Guillain-Barre 
syndrome, back pain, and lumbosacral strain are judged to all be in scope and are addressed 
below.  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  Board  for 
Correction of Naval Records. 
 
 
RATING COMPARISON:  
 

Service PEB – Dated 20030201 
Code 

Condition 

History of protracted weakness of 
BUE and BLE after GBS 
History of GBS 
History of chronic lumbago 
Chronic L/S strain, posttraumatic 

8099-8011 

Cat II 
Cat III 
Cat III 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

Rating 
10% 

VA (7 Mo. Post-Separation) – Effective 20030327 
Condition 

Rating 

Code 

Exam 

GBS w/ L/S strain 

5295-6354 

50%* 

20030311 

0% x 0/NSC x 1 

Combined:  50% 

20030311 

* 50 pre-stabilization through 20040401, dropped to 0% from 20040401, then 10% from 20040402 upon claim for increase. 

 

 

ANALYSIS SUMMARY:   
 
History  of  Protracted  Weakness  of  Both  Upper  and  Lower  Extremities  after  Guillain-Barre 
Syndrome  Condition.    On  25  December  2001,  the  CI  presented  with  a  2  day  history  of  right 
sided low back pain (LBP) which progressed to an ascending paresis of both lower extremities 
(BLE)  and  areflexia.    He  was  diagnosed  with  Guillain-Barre  Syndrome  (GBS)  and  treated  with 
intravenous Immuno-globulin (IVIG) with improvement.  After discharge from the hospital, he 
met a MEB which recommended eight months of LIMDU.  Near the end of the LIMDU period he 
had improved considerably, but still did not meet full duty requirements and he was placed on 
a second 8 month LIMDU period on 24 June 2002.  At a neurology evaluation on 15 October 
2002,  it  was  noted  that  the  CI  remained  unfit  for  full  duty  despite  slow,  continuous 
improvement  and  MEB  was  recommended.    He  was  admitted  the  next  day  for  subjective 
weakness  of  his  legs.    He  improved  on  steroids and  was  discharged  2 days  later.    Four  days 
later,  on  22  October  2002,  his  neurological  examination  was  normal  other  than  persistent 
diminished BLE reflexes.  The CI reported that he had stopped the steroids due to side effects, 
but that his symptoms had not worsened.  The narrative summary (NARSUM) was dictated on 
23  October  2002,  5  months  prior  to  separation.    The  CI’s  main  complaint  was  that  he  was 
expected to work night shifts and stand at quarters for prolonged periods of time despite being 
on  LIMDU.    The  examiner  recorded  that  the  CI  requested  the  MEB.    The  neurological 
examination was normal other that the presence of giveaway weakness, an indication of non-
organic  weakness,  after  exercise  and  hypo-reflexia.    The  cognitive,  cranial  nerve,  sensory, 
motor,  and  cerebellar  examinations  were  normal  as  was  the  gait  and  station.    The  MEB 
examiner  for  the  separation  examination  on  18  November  2002  noted  that  the  CI  had 
somewhat  slurred  speech  (not  documented  elsewhere)  and  diminished  reflexes.    His  last 
neurology follow up was a month later on 16 December 2002.  The examiner noted continued 
improvement in his strength which was assessed at 5/5 (normal) for all muscle groups.  The VA 
Compensation and Pension (C&P) general examination (for the back) was on 11 March 2003 (2 
weeks prior to separation).  It noted only that he had significant dysfunction which would be 
covered by the neurologist.  On examination he was noted to walk slowly with no spring in his 
step.  The reflexes were diminished, but the examiner recorded that there was otherwise no 
specific neurological deficit.  The VA did not accomplish a specific neurological C&P examination 
for the GBS condition until 26 months after separation; it was recorded as essentially normal.  A 
neurological  examination  for  chronic  fatigue  syndrome  had  been  done  5  months  earlier;  it 
documented that the CI had not used assistive devices for walking since discharge and that the 
neurological examination was essentially normal.   
 
The Board directed attention to its rating recommendation based on the above evidence.  The 
PEB coded the GBS condition as 8099-8011, analogous to poliomyelitis, and rated it at 10% for 
residuals.   The  VA  coded  the  condition  as  5295-6354,  lumbosacral  strain  and  chronic  fatigue 
syndrome, and rated it at 50% IAW VASRD §4.28, pre-stabilization, but rated given a permanent 
10%  rating.    While  there  was  evidence  of  continued  improvement  as  demonstrated  by  the 
return  of  the  reflexes  to  normal,  the  Board  determined  that  this  had  no  functional  bearing.  
Otherwise, both the NARSUM and C&P examinations were essentially normal.  Accordingly, the 
CI was stable at separation from a functional standpoint.  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 of the GBS condition. 
 
Contended PEB Conditions.  The CI also contended for chronic back pain and lumbosacral strain 
in his application.  Both were determined by the PEB to be not unfitting or to contribute to the 
underlying unfitting GBS condition.  The Board’s main charge with respect to these conditions is 
an assessment of the fairness of the PEB’s determinations that they were not unfitting.  The 
Board’s  threshold  for  countering  fitness  determinations  is  higher  than  the  VASRD  §4.3 
(reasonable doubt) standard used for its rating recommendations, but remains adherent to the 
DoDI  6040.44  “fair  and  equitable”  standard.    The  CI  first  presented  for  LBP  and  strain  on 

2                                                           PD1201481 

24 November 2001, a month before the onset of the GBS.  He denied a history of trauma, but 
was later noted to have hurt himself lifting boxes.  He had a slight limp and tenderness over the 
lower right back.  An orthopedic examination 2 months later, after the onset of the GBS, noted 
normal X-rays and a magnetic resonance imaging (MRI) exam.  His examination was remarkable 
for the findings from the GBS.  He was treated with medications and light duty.  He continued 
to have LBP over the next year.  The MEB NARSUM recorded normal strength and gait.  The VA 
C&P examiner noted that his gait was slow without a spring to it and that the range-of-motion 
(ROM) slightly reduced due to muscle discomfort.  The commander made no specific comment 
on  the  back  pain.    Both  periods  of  LIMDU  were  solely  for  the  GBS  condition.    Both  back 
conditions  were  reviewed  by  the  action  officer  and  considered  by  the Board.    There  was  no 
performance  based  evidence  from  the  record  that  the  back  pain  or  strain  conditions 
significantly interfered with satisfactory duty performance after the initial injury, over a year 
prior  to  separation.    After  due  deliberation  in  consideration  of  the  preponderance  of  the 
evidence, the Board concluded that there was insufficient cause to recommend a change in the 
PEB fitness determination for the back pain or lumbosacral strain condition; thus no additional 
disability ratings can be recommended. 
 
 
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 history of protracted weakness of both upper and lower 
extremities after GBS condition and IAW VASRD §4.124a, the Board unanimously recommends 
no  change  in  the  PEB  adjudication.    In  the  matter  of  the  contended  chronic  lumbago  and 
chronic lumbosacral strain, post-traumatic, conditions, the Board unanimously recommends no 
change from the PEB determinations as not unfitting.  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 
8099-8011 

10% 

Category II 
Category III 
Category III 

COMBINED 

10% 

UNFITTING CONDITION 

History of Protracted Weakness of Both Upper and Lower 
Extremities After Guillain-Barre Syndrome 
History of Guillain-Barre Syndrome 
History of Chronic Lumbago 
Chronic Lumbosacral Strain, Posttraumatic 

 

 

 

 

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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. 
 
 
 
 
 
 
 
 

 
 
 

X 
Acting Director 
Physical Disability Board of Review 

 

4                                                           PD1201481 

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW  
                                        BOARDS  

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 

Ref:   (a) DoDI 6040.44 

             (b) CORB ltr dtd 04 Apr 13 
 

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for 
the reasons provided in their forwarding memorandum, approve the recommendations of the PDBR 
that the following individual’s records not be corrected to reflect a change in either characterization 
of separation or in the disability rating previously assigned by the Department of the Navy’s 
Physical Evaluation Board: 
 
 
 
 
 
 
 
 
 
 
 
 

-  xformer USMC 
-  xformer USN  
-  xformer USMC 
-  xformer USMC 
-  xformer USN  
-  xformer USMC 
-  xformer USMC 
-  xformer USN  
-  xformer USMC 
-  xformer USN  
-  xformer USMC 
  
 

 
 
 
 
 
 
 
 
 
 
 

 

 

     
 
 
 
 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  x 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

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