RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01437
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090725

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Infantryman, medically separated for “degenerative arthritis of the lumbar spine” with a disability rating of 20%.

CI CONTENTION:  Concurrent condition supports higher rating.  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 - 20090521	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Degenerative Arthritis of the Lumbar Spine	5242	20%	No VA Examination in Evidence	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY: 

Degenerative Arthritis of the Lumbar Spine.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s back condition began in 2004 after a motor vehicle accident while deployed to Cuba.  He reinjured his back during physical training in 2007.  Radiographic studies showed moderate degenerate disc disease at L5-S1 with bilateral foraminal narrowing.  In February 2009, while deployed to Afghanistan the CI slipped on a patch of ice landing of his weapon and a wooden pallet.  He was medically evacuated to Landstuhl and given steroids to reduce the swelling in his spine.  Radiographic studies showed a non-compressed disc protrusion at L5-S1.  The CI was evaluated by neurosurgery and determined not to be a surgical candidate.

The 11 May 2009 MEB NARSUM examination, 1 month before separation, noted complaints of pain aggravated with prolonged sitting and standing.  The pain increased with running, jumping, and road marching.  No bowel or bladder dysfunctions were identified.  No weakness, numbness or tingling in the lower extremities were reported.  Physical examination showed 5/5 (normal) strength in the lower extremities, no atrophy or fasciculation’s, and negative seated and supine straight leg raising bilaterally.  No sensory deficits to light touch or pinprick was present.  Deep tendon reflexes were bilaterally intact.  There was no tenderness, abnormal contour, spasm or guarding.  Range of motion (ROM) was flexion to 60 degrees (normal 90) and combined 195 degrees (normal 240) with painful motion but no changes following repetition.  There was no VA Compensation and Pension examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, coded 5242 (degenerative arthritis of the spine), citing limited ROM.  The panel agreed that a 20% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 60 degrees) reported on the NARSUM examination.  There was no documentation of intervertebral disc syndrome (IVDS) with incapacitating episodes which would provide for a higher rating under that 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 back condition and IAW VASRD §4.71a, the panel unanimously or majority 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 modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150615, w/atchs
Exhibit B.  Service Treatment Record

AR20170008567, XXXXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

	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,					      
						      					
Enclosure