RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX.	CASE:  PD-2015-00875
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20021012

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Combat Engineer, medically separated for “chronic low back pain” with a disability rating of 0%.  

CI CONTENTION:  “Review 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 - 20020619	VARD - 20021022	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299 5295	0%	Chronic Lower Back Pain…	5299-5295	0%	20020830	
Personality Disorder	Not Disqualifying	Major Depressive Disorder (claimed as Bipolar Disorder and Personality Disorder)	9434	10%		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to the service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s low back pain condition began in May 1999 after a parachute landing fall.  

The 17 April 2002 MEB NARSUM examination, 6 months prior to separation, noted complaints of back pain.  X-rays showed six non-rib bearing vertebrae (normal variant) with no soft tissue or bony abnormalities.  The physical examination showed range of motion (ROM) of flexion 95 degrees (normal), extension of 20 degrees (slightly decreased) and all other planes of motion normal.  There were non-physiologic findings (Waddell’s signs) of tenderness to pain with light touch and pain with axial loading.  

At the 8 August 2002 VA Compensation and Pension (C&P) evaluation, 2 months before separation, the CI reported non-radiating back pain.  The physical exam showed a normal posture and gait.  ROM was within normal limits and occurred without restrictions.  Goniometric measurements and the examiner’s normal for each plane were detailed and weakness, lack .of endurance or incoordination did not impact further on the ROM.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the low back pain condition 0%, coded 5299-5295 (lumbosacral strain), citing ROMs and Waddell’s signs.  The VA also rated the low back pain condition 0% coded 5299-5295 (lumbosacral strain), citing no painful or limited motion, but with X-ray findings of six non-rib bearing vertebrae.  

In accordance with DoDI 6040.44, the panel is required to recommend a rating IAW the VASRD in effect at the time of separation.  The panel noted that the 2002 Veteran Administration Schedule for Rating Disabilities (VASRD) standards for the spine, which were in effect at the time of separation, were changed to the current §4.71a rating standards effective 26 September 2003.  The panel must correlate the above clinical data with the 2002 rating schedule (after the VASRD change effective 23 September 2002).  

The panel consensus was that the pre-separation VA examination had the highest probative value for rating at separation as it was closest to separation and addressed DeLuca criteria with repetitive motion.  There was no characteristic pain on motion or muscle spasm on either the Service or VA examinations, and no limited motion on the VA examination.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel majority concluded that there was insufficient cause to recommend a change in the PEB adjudication for the low back pain condition.  

Personality Disorder.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not disqualifying.  In accordance with DoDI 1332.38, E4.13.1.4 and E5, personality disorder is a condition or circumstance that does not constitute a physical disability, and is therefore not compensable.  After due deliberation, the panel concluded that there was insufficient cause to recommend a change in the PEB not disqualifying determination for the contended condition and so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the low back pain condition and IAW VASRD §4.71a, the panel majority recommends no change in the PEB adjudication. The single voter for dissent recommended modification of the disability rating and did not submit a minority opinion.  In the matter of the contended personality disorder condition, the panel unanimously agrees that it cannot recommend it for additional disability rating.  There were no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150601, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170007147, XXXXXXXXXXXXXXXXXX. 

Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,