RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00722
BRANCH OF SERVICE:  Navy	SEPARATION DATE:  20020116

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Electronics Technician, medically separated for “left sacroiliac joint arthropathy” with a disability rating of 10%.

CI CONTENTION:  “Review all conditions.”  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 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 - 20011108	VARD - 20020829	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Sacroiliac Joint Arthropathy	5294	10%	Left Sacroiliac Joint Arthropathy and Degenerative Arthritis	5010	0%	STR	
Refractory Chronic Left Sacroiliac Joint Pain	Cat II					
Sleep Disorder, Insomnia Type, due to Chronic Refractory Low Back Pain	Cat III	No VA Placement	
Adjustment Disorder with Mixed Anxiety and Depressed Mood	Cat III	No VA Placement	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Left Sacroiliac (SI) Joint Arthropathy.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s back condition began in 1998 after a fall during ship duty.

At a 27 April 2001 rheumatology evaluation dated, 7 months before separation, the CI reported morning stiffness, left lower back and buttock pain with activity, sleep disturbance due to the back pain and a 1-month history of left leg numbness.  The examiner noted that the left lower back and buttock pain did not improve despite physical therapy, massage therapy, pain medications, and SI joint injections.  The physical examination showed good back range of motion (ROM) and a non-antalgic gait.  There was mild tenderness over the left SI joint region.  Test for SI dysfunction were positive.  The examiner rendered a diagnosis of post-traumatic degenerative arthritis.  

The 22 May 2001 MEB NARSUM examination, 8 months prior to separation, noted complaints of left lower back and SI joint pain.  The pain was described as sharp and aching.  It was exacerbated by activity.  Physical examination showed normal gait and full spinal ROM.  Lower back and SI joint dysfunction testing was positive.

There was no VA Compensation and Pension examination performed within 12 months post-separation for this panel to review.  The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the back condition 10%, coded 5294 (sacroiliac injury and weakness).  The VA rated the back condition 0%, coded 5010 (traumatic arthritis), based on the STR.

The panel agreed there was insufficient limitation of motion to support a minimum rating for slight lumbar limitation of motion (5292); however, a 10% rating was justified for the presence of characteristic pain on motion (5294).  The evidence did not support a 20% rating for muscle spasm on extreme forward bending, or loss of lateral spine motion, unilateral, in standing position.  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 left sacroiliac joint arthropathy condition.

Contended PEB Conditions:  Refractory Chronic Left SI Joint Pain, Sleep Disorder and Adjustment Disorder.  The Navy PEB listed the refractory chronic left SI joint pain as a related diagnosis (Category II) contributing to the disability in this case.  The panel concluded the Category II diagnosis was not a separate condition which could be reasonably justified as separately unfitting; nor would a separate rating be achievable without violation of VASRD §4.14 (avoidance of pyramiding). 

In the matter of the contended sleep and adjustment disorders, the panel’s main charge is to assess the fairness of the PEB’s determination that these contended conditions were not unfitting.  Neither of these conditions were implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that either of these conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded that there was insufficient cause to recommend a change in the PEB fitness determination for either of these contended conditions and so no additional disability ratings are recommended.

BOARD FINDINGS:  In the matter of the left SI joint arthropathy and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended refractory chronic left sacroiliac joint pain, the panel unanimously agrees that it cannot be recommended for additional disability rating.  In the matter of the contended sleep disorder and adjustment disorder, the panel unanimously recommends no change from the PEB determinations as not unfitting.  There are 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 20150602, 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)