RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00756
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080312

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Signal Collection/Analyst, medically separated for “chronic low back pain [LBP],” with a disability rating of 10%.  

CI CONTENTION:  The CI’s condition continues to worsen and negatively impacts 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 – 20080318	VARD - 20080527	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic LBP	5299-5237	10%	Lumbosacral Muscular Ligamentous Strain	5237	20%	20080310	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic LBP.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s back condition began during Basic Training in September 2004 after falling and landed on her back while wearing full gear.  X-rays in November 2006 were normal, and magnetic resonance imaging (MRI) studies on 1 July 2007 showed a possible evolving spondylolysis (degeneration) at L5.  There was no surgical indication, and conservative treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “chronic LBP” for PEB adjudication.  The MEB NARSUM examination on 4 September 2007 (7 months prior to separation) noted complaints of constant pain which did not radiate.  The physical examination showed a normal gait, normal alignment of the spine, no local tenderness, no abnormal curvature, and no spasm.  Range of motion (ROM) measurements showed a flexion of 60 degrees (90 normal) and a combined ROM of 210 degrees (240 normal).  The CI was able to walk on her heels and forefeet, reflexes were normal, and pin prick sensation was intact.  At the VA Compensation and Pension (C&P) evaluation, performed on 10 March 2008, 2 days before separation, the CI reported pain and stiffness of the lower back.  The CI stated the pain radiated to both hips, more on the left side but no radiation to the lower extremities.  The CI was prescribed a back support.  The CI reported she is able to drive, work, perform activities of daily living, and there is no history of incapacitating episodes or flare ups.  Her back pain was aggravated by lifting, bending over, prolonged sitting and prolonged standing.  The physical examination showed the CI walked without any limp or using any assistive devices other than a lumbosacral elastic support with lumbar pad.  The lumbar spine showed no palpable defect, there was tenderness and tightness.  The neurological examination was normal, and testing for radiculopathy was negative.  The ROM measurements showed a flexion of 40 degrees and combined ROM of 140 degrees.  X-ray studies on 10 March 2008 showed no evidence of fracture or subluxation, no significant disc space narrowing or bony spurring.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, analogously coded 5299-5237 (lumbosacral strain), citing slight limitation of motion.  The VA rated the back condition 20% coded 5237 (lumbosacral strain), based on the VA C&P examination 2 days before separation, citing limitation of forward flexion.  The Board agreed that a 20% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 60 degrees) as reported on the MEB, NARSUM, and VA C&P examinations.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 20% for the back condition, coded 5299-5237.  

BOARD FINDINGS:  In the matter of the chronic LBP condition, the Board unanimously recommends a disability rating of 20%, analogously coded 5299-5237 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  

The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Low Back Pain	5299-5237	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150604, w/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 
XXXXXXXXXXXXXXXXXX, AR20170000081 (PD201500756)

1.  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, accept the Board’s recommendation to modify the individual’s disability rating to 20% without re-characterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

 BY ORDER OF THE SECRETARY OF THE ARMY:

CF: 
(  ) DoD PDBR
(  ) DVA