RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX		CASE:  PD-2014-04175
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20020730

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4 (Administrative Specialist) medically separated for “chronic LBP due to mild facet arthropathy,” rated at 10%.  

CI CONTENTION:  “Please consider all conditions.”  Her 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 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:  

IPEB - Dated 20020422	VA* - (~2 Mos. Post-Separation) 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Low Back Pain due to Mild Facet Arthropathy	5299-5295	10%	Mild Facet Arthropathy of the Lumbar Spine	5009	10%	20020513	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 5 	
RATING:  10%	COMBINED RATING:  40%	
*Derived from VA Rating Decision (VARD) dated 20020731 (most proximate to date of separation (DOS)).  

ANALYSIS SUMMARY:  The VASRD spine coding and rating standards changed with regards to incapacitating episodes in late 2002 and joint range-of-motion (ROM) in 2003.  This case is adjudicated under the standards which were in effect at the time of the CI’s Service separation.  A brief summary of the 2002 rating codes under discussion in this case are excerpted below.

5292 Spine, limitation of motion of, lumbar:
Slight...10%; Moderate...20%; Severe...40%
5293 Intervertebral disc syndrome: Range 0%-60%
	cured 0%; mild 10%; moderate 20%; severe 40%; pronounced 60%
5295 Lumbosacral strain:  Range 0% -40%
subjective symptoms 0%; painful motion 10%; spasms with loss motion 20%; Severe 40%
Low Back Condition.  The CI developed low back pain (LBP) while recovering from abdominal gynecological surgery in October 2000.  Her working diagnosis was likely musculoskeletal due to positioning during surgery.  She denied any component of an extending radiculopathy.  She underwent both urologic and orthopedic workup which included a lumbosacral magnetic resonance image (MRI) that revealed mild to minimal facet arthritis.  Conservative treatment failed to provide pain relief and she was permanently profiled and referred to a MEB in May 2001.  At the MEB orthopedic narrative summary (NARSUM) examination on 12 March 2002 (5 months pre-separation), the CI endorsed nighttime LBP without leg symptoms or bowel/bladder symptoms.  Her physical examination (PE) revealed low back tenderness with spasm.  Thoracolumbar ROM was guarded, decreased and painful.  Neuro sensory and motor parameters were normal.  Her diagnosis remained LBP secondary to mild degenerative joint disease in the facet joints of the lumbar spine.  At the VA Compensation and Pension (C&P) examination on 13 May 2002 (3 months post-separation), the CI reported that her low back condition “does not affect her posture or gait during exercise or walking.”  Her lumbar spine PE was completely normal excepting bilateral strait leg raise without noting a degree of positivity.  The CI’s final diagnosis was lumbar spine strain.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB analogously coded the back condition 5299-5295 (lumbosacral strain), rated 10%.  The VA rated the back condition 10%, coded 5009 (arthritis).  Board members first considered examination probative value and determined that the VA C&P exam be apportioned near exclusive probative value due to it close time reference to the CI’s date of separation.  Utilizing the 5295 (lumbosacral strain) code, Board members agreed that the normality of the probative VA exam does not support an impairment level greater than the current 10% as adjudicated by the PEB.  After due deliberation, considering the totality of the evidence, the Board concluded that there was insufficient cause to recommend a change in the IPEB adjudication for the LBP condition. 

BOARD FINDINGS:  In the matter of the low back condition and IAW VASRD 2002 spine rules, 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

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 AR20160005477 (PD201404175}

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