RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04004
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20021002

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an activated National Guard E-5, Cannon Crew Member, medically separated for a “lumbar spine condition” with a disability rating of 10%. 

CI CONTENTION:  The CI made no specific contention in their application.  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 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 - 20020719	VARD - 20021104	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain…	5293	10%	Multilevel Degenerative Disc Disease	5243	10%	STR	
			Left Lower Extremity Paresthesia	8520	10%	STR	
			Right Lower Extremity Paresthesia	8520	10%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain Condition.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s lower back pain condition began February 2001 after motor vehicle accident.  Magnetic resonance imaging (MRI) studies [March 2001] showed mild herniation of L3-4 with moderate central canal stenosis.  Electrodiagnostic studies (EMG) on02 April 2001, were negative for radiculopathy.  At a neurosurgery consultation the CI was given a recommendation to have surgery for his lower back condition, if there was not any response to steroid injections.  At the MEB NARSUM examination dated February 2002, 8 months prior to separation, the CI complained of persistent low back pain with radiation to the posterior thighs bilaterally, which was exacerbated by walking 3 or 4 blocks.  The CI also stated he had pain when standing for a prolonged period.  He denied numbness in the lower extremities.  The CI noted that he was not taking any medications.  Physical examination showed forward flexion to within approximately one foot of the floor and mildly decreased range of motion with lateral bending and lateral rotation.  EMG/ nerve conduction studies did not show any abnormalities.  MRI demonstrated disc herniation and central canal stenosis.  At a physical therapy examination in May 2005, the CI was found to have full range of motion with normal gait and strength.  There was not a VA C&P examination for review.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating under the 5293 code (Intervertebral Disc Syndrome), citing spasms with characteristic pain on motion.  The VA also assigned a 10% rating using the analogous 5293-5292 code (spine limitation of motion, lumbar) based on the service treatment records (STR).  The Board agreed a 10% rating was justified due to the slight limitation of motion and characteristic pain on motion.  There was no evidence of intervertebral disc syndrome resulting in incapacitating episodes requiring bed rest prescribed by a physician to warrant consideration of rating under the alternate VASRD formula based on incapacitating episodes due to intervertebral disc syndrome.  There was no evidence of an associated unfitting radiculopathy for consideration of a separate peripheral nerve 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 low back condition.  

BOARD FINDINGS:  In the matter of the lower 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.  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 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-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
AR20160017769 (PD-2014-04004)

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