RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01011
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20090123

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Fuels Laboratory Technician, medically separated for a “burst fracture T-12 with fusion T11-L1,” with a  disability rating of 10%.

CI CONTENTION:  The CI requested a review of 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 - 20081002	VARD – NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Burst Fracture T-12 with Fusion T-11-L1	5241	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Burst Fracture T-12 with Fusion T11-L1.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s back condition began in September 2006 while jumping on a trampoline.  A T-12 compression fracture required surgical excision of the T-12 vertebra and adjacent discs and replacement with a cage graft, with plate fusion of T11-L1.  Post-operatively the CI progressed quite well and became virtually asymptomatic, however imposed profile restrictions (no lifting greater than 30 pounds, no repetitive twisting or bending) prevented fulfillment of the physical requirements of the CI’s military specialty.

A goniometric range of motion (ROM) evaluation performed by physical therapy (PT) on 21 February 2008 (11 months prior to separation) recorded flexion of 80 degrees (normal 90 degrees) and combined ROM of 195 degrees (normal 240 degrees).  The MEB NARSUM examination on 5 March 2008 reported that the CI was relatively free of pain and able to work out on a bike, but was restricted by the neurosurgeon from performing push-ups and sit-ups, lifting more than 30 pounds, or running.  Physical examination showed “limited motion of the thoracolumbar spine” but an ability to touch his toes.  There was no tenderness or pain during flexion.  At a neurosurgical follow-up on 23 September 2008, 4 months prior to separation, the CI stated that his desire was to remain in the service if given the opportunity to engage in a specialty that did not require heavy lifting.  Physical examination showed the ability to touch his fingertips to his toes.  Lower extremity neurologic findings were normal.  The examiner concluded that, with stable X-rays, the CI could continue in a job that did not require frequent twisting or bending, or lifting greater than 35 pounds.  X-rays completed 2 days later showed no spondylolisthesis (vertebral slippage).  There was minimal kyphosis centered at T-12.  

There was no VA examination in evidence within the 12-month allowable window for adjudication.  

The panel directed attention to its rating recommendation based on the above evidence.  The Formal PEB rated the back condition 10%, coded 5241 (spinal fusion).  The panel agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 60 degrees but not greater than 85 degrees) and combined ROM (greater than 120 degrees but not greater than 235 degrees) reported on the PT examination.  There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis.  There was no evidence of intervertebral disc syndrome (IVDS) which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under the alternate VASRD formula (for IVDS).  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 back condition.

BOARD FINDINGS:  In the matter of the “burst fracture T-12 with fusion T11-L1” condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  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 20150608, w/atchs
Exhibit B.  Service Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-01011.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings