RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE:  PD-2014-00285
BRANCH OF SERVICE:  Army  	 SEPARATION DATE:  20080327

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E-5, Petroleum Supply Specialist, medically separated for “chronic low back pain,” with a disability rating of 20%. 

CI CONTENTION:  “At the time of the Medical Board, I was found unfit to conduct my job.  I was then placed on a P3 profile and med boarded.  I was encouraged by my case manager to accept the severance pay and not challenge the decision as it would complicate my med board and slow down me being medically discharged.  I also wanted to have my other medical issues added, but I was advised to do it after my discharge.” Her complete submission, with attachments, is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the PEB to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation. 

RATING COMPARISON:  

SERVICE PEB - 20080418	VARD - 20080403 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Low Back Pain	5237	20%	Residuals of Lumbar Spine Cyst	7819-5237	20%	20080403	
Other x 0 (Not in Scope)	Other x 9		
Rating:  20%	Combined:  40%	

ANALYSIS SUMMARY:   

Low Back Pain (LBP).  This CI has a long history of LBP.  He was treated with medication, physical therapy (PT), and transcutaneous electrical nerve stimulation (TENS).  In spite of all treatment efforts, his LBP persisted and a Medical Evaluation Board (MEB) was initiated.  The MEB narrative summary (NARSUM) was dated 3 December 2007.  At the MEB exam, the CI reported that his LBP was worse with running, bending, kneeling, or prolonged standing. On physical examination (PE) of the back, the straight leg raise (SLR) test was negative bilaterally, and no muscle spasm was noted.  Thoracolumbar range-of-motion (ROM) was measured by PT, and is summarized in the chart below.   

The CI was medically separated  on 27 March 2008.  One week later, on 3 April 2008, he had a VA Compensation and Pension (C&P) exam.  He was working as a fuel manager, and was able to attend to his daily activities.  He reported that his pain was constant, and was aggravated by prolonged walking, prolonged sitting, or standing.  On PE, the CI was in no acute distress.  Gait and station were normal.  On PE of the lower back, there was some tenderness to palpation (TTP), but no spasm or guarding was noted.  Normal spinal contour was preserved, and no neurological findings were noted.  

The Board directed attention to its rating recommendation based on the evidence.  At both of the ROM exams described above, thoracolumbar forward flexion was greater than 30 degrees, but not greater than 60 degrees.  IAW the VA Schedule for Rating Disabilities (VASRD) §4.71a General Rating Formula for Diseases and Injuries of the Spine, a 20% disability rating is warranted when thoracolumbar forward flexion is greater than 30 degrees, but not greater than 60 degrees.  Therefore, the Board determined that a 20% rating was appropriate in this case.  The Board tried to find a path to a higher rating.  There was no path to a higher rating, because the record did not show sufficient evidence of a seriously disabling back condition or spinal abnormality which would justify a higher rating.    

The Board also considered the matter of radiculopathy.  After review of all the information in the record, there was insufficient evidence of a clinically significant radiculopathy that interfered with performance of military duties.  Therefore, the Board concluded that there was no unfitting radiculopathy present at the time of separation.  Considering all of the evidence and mindful of VASRD §4.3 (Reasonable doubt), the Board found insufficient cause to recommend a change in the PEB adjudication of the low back pain condition.

BOARD FINDINGS:  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. The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20131031, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXX, AR20160005436 (PD201400285)

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:

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA