RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE:  PD-2014-00889
BRANCH OF SERVICE:  Army	 SEPARATION DATE:  20060320

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Army National Guard duty E4, Imagery Analyst, medically separated for “chronic low back pain due to degenerative disc disease,” with a disability rating of 10%.

CI CONTENTION:  The CI asserts he did not receive a CT or MRI and his condition is more severe than determined by the Service and that he also has problems with his neck.  His complete submission 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 Physical Evaluation Board (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 - 20060123	VARD - 20050916	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain due to Degenerative Disc Disease	5299-5242	10%	Thoracolumbar Strain, with Narrowing at L5-S1 Vertebra and Hypertrophy at L5	5299-5242	10%	20041217	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Back Pain Condition.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI initially developed lower back pain (LBP) presumably from increased running in early 2003.  Radiographs eventually revealed degenerative disc disease (DDD) with herniation at L4-5 spinal level.  Electrodiagnostic studies did not reveal a lower extremity radiculopathy or neuropathy.  His treatment remained non-surgical with medication, physical therapy (PT), and local injections.  He was permanently profiled in December 2005 and referred to an MEB.  At the MEB examination (performed 4 months prior separation), the CI reported a mild LBP aggravated by strenuous activity, prolonged standing/sitting, or maneuvering stairs.  He also endorsed pain extending into his left leg.  “His back pain occurs on most days but is not as constant as his leg pain.”  His civilian occupation was noted as a “correction officer.”  The MEB physical examination (PE) noted tenderness about the lumbar spine.  Thoracolumbar range-of-motion (ROM) was decreased.  There was no comment in relation to the presence of painful motion and his gait was normal.  The examiner noted under “current condition” that “There is no electro-physiologic evidence of radiculopathy.”  His diagnosis remained as DDD indicating “slight and frequent” symptoms.  At the VA Compensation and Pension (C&P) examination performed on 17 December 2004 (15 months prior to separation), the CI reported having sporadic and localized mid to low back pain elicited by physical activity, particularly bending and running.  He additionally reported “no functional impairment.”  The examination revealed a normal gait and posture.  There was ‘slight’ tenderness in the mid-thoracic spine and decreased thoracolumbar ROM.  

The Board directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA applied similar primary codes of 5242 (degenerative arthritis) and rated 10%.  Board members first agreed that sufficient evidence of localized tenderness not resulting in abnormal gait or spinal contour was present at the MEB exam to justify the PEB rating of 10% IAW VASRD §4.71a.  Members then considered and deliberated whether a separately ratable neuropathy existed with functional impairment linked to fitness near the time of separation.  Members concluded that despite having subjective complaints of a lower extremity neuropathy at the MEB examination, the objective evidence of a normal electro-physiologic test did not coincide with a separately unfitting radiculopathy condition, and therefore, cannot be recommended for additional disability rating.  Additionally, any 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 concluded that there was insufficient cause to recommend a change in the PEB adjudication of the low back condition.

BOARD FINDINGS:  In the matter of the chronic 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.  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 20140213, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXX, AR20160005834 (PD201400889)  

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