RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03901
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20071021

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Avionic and Survivability Equipment Repairer, medically separated for “chronic low back pain,” with a disability rating of 10%.

CI CONTENTION:  The CI requested consideration of all conditions. 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 upon a 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 - 20070814	VARD - 20071226	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain … Grade I Spondylolithesis L5-S1	5239	10%	Degenerative Disc Disease ... Spondylolithesis L5-S1	5003-5237	10%	20071217	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Lumbar Spine.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI suffered an onset of chronic low back pain in October 2005.  There was no radiation or associated neurological complaints.  Imaging (X-ray, MRI) demonstrated mild (Grade 1) spondylolisthesis (slippage of one vertebra over the other) and “very mild, multi-level degenerative changes” without nerve impingement.  There were multiple STR entries documenting normal gait, grossly normal range of motion (ROM), and normal neurological findings (5/5 strength); with no STR entries to the contrary and no STR documentation of abnormal spinal contour or incapacitating episodes.  Surgery was not indicated; conservative treatment did not result in improvement sufficient to allow unrestricted duty; and, the CI was referred for MEB which in turn forwarded “chronic low back pain secondary to grade I spondylolisthesis with spondylolysis” to the PEB.  

At the NARSUM examination on 26 June 2007, performed 4 months prior to separation, the CI reported chronic pain aggravated by lifting and prolonged sitting or standing.  The physical examination recorded a normal gait, tenderness, grossly normal ROM (with painful motion), and detailed normal neurological findings with 5/5 strength.  There were no formal goniometric ROM measurements located in the service file.

At the 17 December 2007 VA Compensation and Pension (C&P) evaluation, performed 2 months after separation, the CI reported low back pain that was aggravated by lifting objects, running, and exercising.  Radicular symptoms were denied.  The physical examination recorded a normal gait, tenderness, and detailed normal neurological findings with 5/5 strength.  Measured ROM was flexion to 90 degrees (normal) and combined ROM of 240 degrees (normal), specifying painful motion.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated 10% under code 5239 (spondylolisthesis), citing tenderness.  The VA rated 10% under code 5003-5237 (degenerative arthritis rated as lumbar strain) referencing the C&P findings.  Based on the ROM evidence, painful motion (or tenderness as per the PEB) must be conceded to achieve the minimum compensable rating of 10%.  There was no evidence for abnormal gait or contour to support a 20% rating, no evidence for ratable peripheral nerve impairment which would provide for additional rating, and no documentation of incapacitating episodes which would provide for a higher rating under that formula.  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 lumbar spine condition.

BOARD FINDINGS:  In the matter of the lumbar spine 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 20140827, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB
						
04 AUG 2016

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 (PD201403901)

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