RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03372
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090131

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4, Infantry, medically separated by the Informal Physical Evaluation Board (IPEB) for “LBP with early disk degeneration” with a disability rating of 10%. 

CI CONTENTION:  His condition continues to worsen and negatively impact his daily activities.  The applicant’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 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:  

SEVICE PEB – 20081204	VARD - 20090702	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Low Back Pain With Early Disc Degeneration	5242	10%	Strain, Lumbar Strain, With L3-L4 Internal Desication	5237	10%	20090529	
Other Conditions x 0 (Not In Scope)	Other x 1	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Low Back Pain (LBP) Condition.  Absent direct trauma, the CI insidiously developed LBP without radicular symptoms in September 2007 and first sought medical treatment in April 2008.  X-rays of the thoracolumbar spine were normal.  A magnetic resonance image performed on 25 July 2008 revealed disc bulging of L3-L4 without evidence of herniation.  Despite conservative treatment including manipulation and aggressive physical therapy (PT), his pain continued and he was permanently profiled in October 2007 with a diagnosis of LBP, bulging intervertebral disc.  At the Medical Evaluation Board (MEB) narrative summary (NARSUM) examination, the CI reported LBP without radicular symptoms.  He endorsed the inability to run, participate in any type of sports, wear Kevlar, or lift over 15 pounds.  His physical examination (PE) revealed full, but painful thoracolumbar range-of-motion (ROM).  The diagnosis remained early intervertebral disk degeneration at L3-4, without evidence of radiculopathy.  At the VA Compensation and Pension (C&P) examination, the CI reported severe, near constant LBP with weekly flare-ups causing the inability to bend over or lift.  His PE revealed decreased thoracolumbar ROM without pain.  He remained neurologically intact with normal strength to both lower extremities.  
The Board directed attention to its rating recommendation based on the above evidence.  Both the PEB and VA applied similar codes of 5242 (degenerative arthritis) and 5237 (lumbosacral strain) respectively, which was appropriate to the presenting pathology.  The Board agreed that either examination (pre or post separation) supported a 10% rating by painful motion IAW §4.59 or limited motion IAW §4.71a, respectively.  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’s adjudication for the LBP condition. 

BOARD FINDINGS:  In the matter of the 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 20140627, 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-00), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557
JUL 1 4 2016

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXX, AR20160005135 (PD201403372)
	
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
( ) OVA
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