RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04111
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20030221

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Light Wheeled Vehicle Mechanic, medically separated for “chronic low back pain,” with a disability rating of 10%.

CI CONTENTION:  “Please consider 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 - 20021120	VARD - 20040106	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5295	10%	Degenerative Disc Disease; Lumbar Spine	5293	0%	20040106
No Show	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:    

Chronic Low Back Pain.   According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s back condition began in January 2001 after a road march.  At the MEB examination (recorded on DD Form 2807 Report of Medical History and DD Form 2808 Report of Medical Examination) dated October 2002, 3 months prior to separation, the CI reported constant and slight lower back pain.  The NARSUM physical examination showed no back deformities or tenderness.  There was painful and decreased flexion to 55 degrees (normal is 90 degrees), extension to 15 degrees (30 degrees), and right lateral bending to 25 degrees (30 degrees).  He had positive radicular testing on the right.  Deep tendon reflexes in the lower extremities were normal.  Radiographic studies in May 2005 showed disk space narrowing at the L5 S1 and no acute abnormalities.  The MRI showed herniated lumbar discs with nerve impingement.  There was no surgical indication and conservative treatment did not result in improvement sufficient to allow unrestricted duty. The MEB forwarded “degenerative disc disease lumbar spine with sciatica” for PEB adjudication.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating under an analogous 5299-5295 code (lumbosacral strain), citing characteristic pain on motion and citing application of the Department of Defense Instruction (DoDI) 1332.39 and AR 635.40 Appendix B-39.  The VA rated the condition 0% under 5293 (intervertebral disc disease), citing the absence of recent medical evidence because the CI did not report to the examination.  There was no evidence of muscle spasm on extreme forward bending, loss of lateral spine motion, unilateral, in standing position for a higher rating under 5295.  There was no evidence of incapacitating episodes having a total duration of at least two weeks, but less than four weeks during the past 12 months for a higher rating under 5295; however, the Board determined that the limitation of flexion to 55 degrees and extension to 15 degrees, at the PEB examination, with painful motion met criteria for a 20% rating for moderate limitation of motion under 5292 (spine, limitation of motion of lumbar).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a rating of 20% for the lower back pain condition with code 5292.  

BOARD FINDINGS:  In the matter of the chronic lower back pain condition, the Board unanimously recommends a disability rating of 20%, coded 5292 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Low Back Pain	5292	20%	

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

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 AR20160013686 (PD201404111)

1.  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, accept the Board’s recommendation to modify the individual’s disability rating to 20% without re-characterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

 BY ORDER OF THE SECRETARY OF THE ARMY:

CF: 
(  ) DoD PDBR
(  ) DVA