RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00186
BRANCH OF SERVICE:  Marine Corps	SEPARATION DATE:  20020930

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Finance Technician, medically separated for “multilevel lumbar degenerative disc disease,” with a disability rating of 10%.

CI CONTENTION:  “Please consider all conditions.”  The complete submission is at Exhibit A.

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(s) at the time of separation.  The panel 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 panel 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 - 20020701	VARD - 20040121	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Multilevel Lumbar DDD	5299-5295	10%	S/P  Laminectomy and fusion of the Lumbar Spine, L5-S1	5237	10%	20040121	
L5/S1 Spondylolisthesis, S/P L5/S1 Fusion	Category II	Residuals Surgical Scar of the Lower Back	7805	0%	20040121	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Multilevel Lumbar Degenerative Disc Disease.  The L5/S1 spondylolisthesis, S/P L5/S1 PLIF was adjudicated by the PEB as a category II condition (“Conditions that contribute to the unfitting conditions”).  This condition will be discussed under the unfitting “multilevel lumbar degenerative disc disease (DDD)” below.  

According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s low back pain (LBP) condition began in May 2001 after heavy lifting.  The CI underwent a lumbar interbody fusion on 25 January 2001.  Radiographic (MRI) study done in March 2001 showed spondylolisthesis of the L5 with bilateral pars defects and DDD most significant at the L5/S1 level.  The MEB NARSUM examination on 2 April 2002, 6 months prior to separation, noted complaints of LBP which increased with activity, muscle spasm, and tightness.  The physical examination showed limitation of flexion to 75 degrees (normal 90); painful motion not addressed.  There was no tenderness to palpation, muscular atrophy, weakness, or sensory deficits.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the multilevel lumbar DDD condition 10%, analogously coded 5299-5295 (lumbosacral strain), citing pain on motion.  The PEB also adjudicated the spondylolisthesis as a Category II condition.  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 VASRD coded 5295.  Panel members agreed that neither the lumbar limitation of motion or DDD incapacitating episodes evidenced in the STR supported a 20% under VASRD codes 5292 (lumbar limitation of motion) or 5293 (intervertebral disc syndrome.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the multilevel lumbar DDD condition.

Contended PEB Condition:  L5S1 Spondylolisthesis Status Post L5/S1 Fusion:  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting. The contended condition was coded as a Category II condition (“Conditions that contribute to the unfitting conditions”).  This pain resulting from this condition was considered and subsumed under the rating for the unfitting condition IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited).  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB Category II adjudication and so no additional disability rating is recommended.

BOARD FINDINGS:  In the matter of the multilevel lumbar DDD condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the L5S1 Spondylolisthesis, S/P L5/S1 PLIF contended condition, the panel unanimously recommends no change from the PEB determination as Category II.  There were no other conditions within the panel’s scope of review for consideration.  The panel, 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 20150225, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 26 Apr 17

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXXXXX, former USMC 
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USMC

				   XXXXXXXXXXXXXXXXXXXXX
	     			   Assistant General Counsel
						                (Manpower & Reserve Affairs)