RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03289
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20051025

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Munitions System Craftsman, medically separated for “chronic back pain due to degenerative disk disease [DDD],” with a disability rating of 20%.    

CI CONTENTION:  The CI contends his unfitting back condition. The CI’s 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 based on 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 - 20050913	VARD - 20060405	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain Due to DDD	5243	20%	Degenerative Changes, Thoracolumbar Spine	5242	0%	20060310	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Back Pain Due to DDD.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s back condition began in 2002 without a history of injury.  Radiologic studies showed degenerative disc changes from T7-T12, with a bulging disc at T11-T12.  Surgery was not indicated.  Despite conservative treatment, the CI’s back condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and he was referred for an MEB.  The MEB forwarded “chronic back pain” for PEB adjudication.  An orthopedic evaluation, on 16 April 2005, 6 months prior to separation, reported mid-back pain that was 4-5/10 in severity.  He could stand for 15 minutes, walk a mile, drive and perform daily activities.  Physical examination showed tenderness of the mid-thoracic spine.  There was no spasm and no spinal deformity.  He could walk on heels and toes.  Flexion was 40 degrees (normal 90 degrees) and extension 30 degrees (normal 30 degrees).  There was no evidence of nerve root irritation and lower extremity neurologic findings were normal.  The examiner advised discontinuance of activities that caused pain, such as running.  At the MEB NARSUM examination, on 25 May 2005, 5 months prior to separation, the CI reported chronic back pain.  Physical examination showed a non-tender lumbar spine.  The back showed full range of flexion, extension and rotation, but measurements were not provided.

At the VA Compensation and Pension (C&P) examination, on 3 March 2006, 5 months after separation, the CI reported continuous back pain that did not affect his occupation, or daily or recreational activities.  Physical examination showed normal posture, gait, and spine curvature.  Thoracolumbar flexion was 90 degrees and combined range of motion was 240 degrees (normal 240 degrees).  Painful motion was absent and there was no loss of motion after repetition.  Lower extremity neurologic findings were normal.  Spine tenderness was not mentioned.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 20% rating under the 5243 code (intervertebral disc syndrome).  The VA assigned a 0% rating using the 5242 code (degenerative arthritis of the spine) based on the VA C&P examination, 5 months after separation, citing normal, painless range of motion.  The Board agreed that a 20% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 60 degrees) reported on the orthopedic examination 6 months prior to separation.  There was no documentation of intervertebral disc syndrome (IVDS) with incapacitating episodes which would provide for a higher rating under that formula (for IVDS), and no evidence of ratable peripheral nerve impairment which would provide for additional rating.  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 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 20140710, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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

Dear XXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2014-03289.

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,

Attachment:
Record of Proceedings