RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04313
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20061029

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Light Wheeled Vehicle Mechanic, medically separated for “chronic back pain due to lumbar degenerative disc disease without neurologic abnormality,” with a disability rating of 10%.

CI CONTENTION:  The CI contends his neck, PTSD and depression.  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 on 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 - 20060926	VARD - 20071011	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain due to Degenerative Disc Disease	5299-5242	10%	Lumbar Spine, Degenerative Disc Disease w/Chronic Pain 	5003-5243	20%	20070813	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Chronic Back Pain due to Degenerative Disc Disease.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s low back condition began in 2005 with no specific injury.  The MEB forwarded chronic low back pain due to degenerative disc disease for PEB adjudication.  The MEB NARSUM examination on 7 September 2006 (2 months prior to separation) noted complaints of low back pain that was worse with prolonged sitting or standing.  The CI denied radicular symptoms and incapacitating episodes.  Physical examination showed thoracolumbar range of motion (ROM) of forward flexion 70 degrees, extension 20 degrees, right rotation 30 degrees, left rotation 30 degrees, lateral flexion to the left 20 degrees and lateral flexion to the right 30 degrees.  ROM was accompanied by and limited by pain.  There was no tenderness or spasm.  At the 13 August 2007 VA Compensation and Pension (C&P) evaluation (performed 10 months after separation) the CI reported he could not run, walk long distances, bend, or do heavy lifting due to back pain.  He did not report any incapacitating spells.  Physical examination showed forward flexion 50 degrees, extension 15 degrees, lateral flexion 25 degrees bilaterally and rotation 25 degrees bilaterally with pain on motion.  

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the low back condition 10%, analogously coded 5299-5242 (degenerative arthritis of the spine), citing motion limited by pain and localized tenderness.  The VA rated the low back condition 20% analogously coded 5003-5242 (arthritis, degenerative - degenerative arthritis of the spine), based on the VA C&P examination, citing limitation of forward flexion.  The 11 Oct 2007 VARD is based on a single examination 10 months after separation.  All submitted examinations in the year prior to separation and subsequent VA C&P examinations record a ROM with forward flexion greater than 60 degrees and a combined ROM greater than 120 degrees justifying a 10% rating.  The CI did not have any evaluations proximate to separation with thoracolumbar flexion 60 degrees or less or a combined ROM less than 120 degrees; therefore, a 20% rating is not supported.  There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis.  There was no documentation of intervertebral disc syndrome (IVDS) with incapacitating episodes which would provide for a higher rating under that formula (for IVDS), or evidence of ratable peripheral nerve impairment which would provide for additional 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 low 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 20140811, 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 
XXXXXXXXXXXXXXXXXX, AR20160018402 (PD201404313)

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