RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00134
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20060819

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Cryptologic Linguist, medically separated for “low back pain” with a disability rating of 10%.

CI CONTENTION:  The CI’s conditions continue to worsen and negatively affect daily activities.  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 - 20060425	VARD - 20080826	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Low Back Pain	5299-5237	10%	DDD Lumbar Spine	5243	10%	20080811	
			Radiculopathy, Left Lower Extremity	8599-8520	10%	20080811	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Low Back Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s low back pain condition began in 1998 while playing basketball.  He reinjured his back in 2003 while moving furniture.  Despite, physical therapy, injections and medication, the condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty.  The MEB forwarded “chronic low back pain” to the Physical Evaluation Board (PEB) for adjudication.  At the MEB NARSUM in March 2006, 5 months before separation, the CI reported his back pain was aggravated by prolonged sitting and standing, getting up too quickly from a seated position, and bending.  The CI stated he ran 6 miles 3 times a week and had occasional left lower extremity radiating pain.  The examination revealed tenderness to the lumbar area.  The range of motion (ROM) measurements were flexion to 112 degrees (normal 90), extension to 20 degrees (normal 30), and a combined ROM of 230 (normal 240) with painful motion.  The CI filed his Veterans Administration (VA) on 15 January 2008.  The resulting VA examination in August 2008 was well outside the 12 month post-separation window to accord high probative value for rating at separation.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the low back condition 10% coded 5299-5237 (analogous for lumbosacral strain), citing spine tender to palpation.  The VA also rated the low back condition 10% coded 5243 (intervertebral disc syndrome), based on the VA C&P examination 24 months after separation, citing limited ROM.  The VA additionally rated the left lower extremity radiculopathy at 10%, coded 8599-8520 (analogous to mild, incomplete sciatic nerve paralysis).  The Board agreed the STR evidence supports a 10% rating for localized tenderness not resulting in abnormal gait or abnormal spinal contour.  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.  Additionally, the Board did not find evidence of intervertebral disc syndrome with incapacitating episodes which would provide for a higher rating under that formula or evidence of ratable peripheral nerve impairment which significantly interfered with satisfactory duty performance at separation; therefore, an additional rating is not recommended.  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 pain 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 20150204, with attachments
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 XXXXXXXXXXXXXXXXXXXXX, AR20170002533 (PD201500134)

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