RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXX	CASE:  PD-2014-01553
BRANCH OF SERVICE:  AIR FORCE	SEPARATION DATE:  20071217 

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an activated Reserve E-6 (Avionic Systems Craftsman) medically separated for degenerative disc disease (DDD).  The back condition could not be adequately rehabilitated to meet the physical requirements of her Air Force Specialty.  She was issued a temporary P4 profile and referred for a Medical Evaluation Board (MEB).  The Informal PEB adjudicated “DDD of L5-S1 with L5-S1 nerve root irritation” as unfitting, rated 20% citing application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated.  

CI CONTENTION:  Her condition continues to worsen and negatively impact her daily activities.  Her complete submission is at Exhibit A.

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 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/Naval 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 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 

IPEB - Dated 20071030	VA* - (~10 Mos. Post-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Degenerative Disc Disease	5242	20%	Degenerative Disc Disease At L4-L5 And L5-Sl	5243	10%	STR	
Other MEB/PEB Conditions x 0 (Not in Scope)	Other x 5 	
RATING:  20%	RATING:  10%	
*Derived from VA Rating Decision (VARD) dated 20081001 (most proximate to date of separation (DOS)). Most recent C&P exam was completed 20051108. 

ANALYSIS SUMMARY:  

Low Back Condition.  According to disability derived documentation, the CI developed LBP in 1993 presumably due to “moving objects on the flight line” and has continued to have intermittent symptoms with extension into her right buttock for years.  The service treatment record (STR) is void of clinical documentation prior to August 2001.  A magnetic resonance image and a nerve conduction study performed in 2005 revealed L4-S1 DDD with herniation and right tibia neuropathy, respectively.  An orthopedic evaluation on 13 April 2007 (8 months prior to separation) revealed normal thoracolumbar range-of-motion (ROM) excepting flexion to 60 degrees.  Painful motion and tenderness were present.  Despite extensive conservative therapy, her symptoms intermittently continued throughout her remaining tenure.  She continued on a temporary profile and was referred to a MEB.  At the MEB narrative summary examination (17 July 2007; 5 months prior to separation), she endorsed the inability to “stand or sit for extended periods of time without having to get up and move.”  Her physical examination revealed a normal gait.  All parameters of her thoracolumbar ROM (except forward flexion) were described as the ability to perform “without much discomfort.”  Forward flexion was described as “within 12 inches of the floor.”  Distal motor and sensory components were normal.  

The most current VA Compensation and Pension (C&P) examination in the case file was nearly 25 months prior to separation; and therefore, was not considered as probative in the Boards recommended impairment rating.  

The Board directed attention to its rating recommendation based on the above evidence.  IAW VASRD §4.71a general spine formula, the ROM findings rated by the MEB was 20% and 10% by the VA.  There was no evidence of VASRD defined incapacitating episodes to achieve a higher rating under an alternate rating code.  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 for the low back condition.  The Board additionally considered if the right tibial neuropathy warranted a separate Service disability rating; but, members agreed that the requisite link of the neuropathy symptoms with functional impairment was not in evidence.  The evidence of normal distal motor and sensory components to the lower extremities did not reflect a true radicular or neuropathic adverse condition.  Additionally, any pain component of a radiculopathy/neuropathy is subsumed under the general spine rating as specified in §4.71a.  The Board concluded therefore that any neurologic  condition could not be recommended for an additional disability rating.   

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 low back 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.

RECOMMENDATION:  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 20140401, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2014-01553.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings 

cc:
SAF/MRBR