RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXXX		CASE:  PD-2015-00199
BRANCH OF SERVICE: Army 				    SEPARATION DATE: 20080427   

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4, Unit Supply Specialist, medically separated for “right lower extremity radiculopathy,” and “herniated discs L4-5 and L5-S1,” rated 10% and 0% respectively with a  combined disability rating of 10%.  

CI CONTENTION:  The CI contends for her unfitting condition.  The 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 confined to 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 - 20080305	VARD - 20090306	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Lower Extremity Radiculopathy	8520	10%	No VA Entry	
Herniated Discs L4-5, L4-S1	5243	0%	Intervertebral Disc Syndrome With Degenerative
Arthritis Changes	5243	10%	20081229	
COMBINED RATING:  10%	COMBINED RATING FOR ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Lower Extremity Radiculopathy And Herniated Discs L4-5, L4-S1.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right lower extremity radicular pain condition began in during basic training.  An MRI in July 2007 demonstrated two herniated lumbar spine.  The CI was treated with physical therapy, activity modification, and anti-inflammatory medications.  Evaluation by orthopedics in October 2007 noted reports of persistent 5/10 lower back pain.  The examiner documented that the CI was pregnant and on Motrin for pain management.  The physical examination revealed normal thoracolumbar range of motion.  There was lumbosacral tenderness to palpation.  There was no evidence of muscle spasms and radicular testing was negative.  Despite treatment, the back condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for MEB.  The MEB forwarded herniated lumbar discs (L4-L5, L5-S1) with neuritis for PEB adjudication.  

During the March 2008 MEB examination (recorded on DD Forms 2807 and 2808) 2 months prior to separation, showed an “equivocal”, positive radicular test on the right and slight right leg weakness.  The reflexes were noted as brisk (normal).  

The 19 March 2008 MEB NARSUM examination, 2 months prior to separation, noted complaints of lower back pain.  The physical examination showed the lower back was not tender to palpation and without spasm or guarding.  The thoracolumbar range of motion was “grossly normal”.  Lower extremity strength was normal except for 4/5 right leg extension strength.  

At the 29 December 2008 VA Compensation and Pension (C&P) examination, performed 8 months after separation, the CI reported pain in the constant lower back which radiating down legs.  The pain was rated 8/10, worsened with physical activity, and relieved with rest.  The physical examination showed no evidence of radiating pain on movement.  Muscle spasm was absent and there was not any tenderness to palpation.  There was a positive radicular test (straight leg raising) on the right.  Thoracolumbar range of motion was normal except for painful motion occurring at 88 degrees of forward flexion.  

The Board directed attention to its rating recommendation based on the above evidence.  

The PEB rated the RLE condition 0%, coded 5243 (Intervertebral disc syndrome), citing the absence of tenderness, spasm, and abnormal gait.  The PEB rated the right lower extremity radiculopathy at 10% under 8520 (sciatic nerve), citing mild incomplete paralysis.  The VA rated the RLE 10% coded 5243, based on the VA C&P examination, 8 months after separation, citing incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months.  

There was no limitation of thoracolumbar spine motion to support a minimum rating under the General Rating Formula for Diseases and Injuries of the Spine and the MEB examination did not note the presence of painful motion, muscle spasm, guarding or localized tenderness.  There was no history or evidence of vertebral body fracture with loss of 50 percent or more of the height, nor was there evidence of additional functional loss that would impact functioning in the average civil occupation.  There was no evidence of intervertebral disc syndrome resulting in incapacitating episodes requiring bed rest prescribed by a physician to warrant consideration of rating under the alternate VASRD formula based on incapacitating episodes due to intervertebral disc syndrome.  There was no evidence of foot drop or other gait disturbance, moderate impairment of the muscles below the knee, or decreased flexion of the knee for a rating of 20% for moderate incomplete paralysis.  

Considering the totality of the evidence and mindful of VASRD §4.3 (reasonable doubt), members agreed that a disability rating of 10% for the right lower extremity radiculopathy and 0% for the lower back pain condition were appropriately recommended in this case.  

BOARD FINDINGS:  In the matter of the lower back pain and right lower extremity radiculopathy conditions and IAW VASRD §4.71a and 4.124a, the Board unanimously or majority recommends no change in the PEB adjudications.  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 20140416, 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 XXXXXXXXXXXXXXXXXXXXX, AR20170003448 (PD201500199)

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