RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01761
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040730

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Mortar Man, medically separated for “chronic subjective low back pain” with a disability rating of 10%.

CI CONTENTION:  “Review all conditions.”  The CI’s 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 - 20040407	VARD – NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Subjective Low Back Pain…	5299-5237	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Subjective Low Back Pain (LBP) without Significant Neurologic Abnormality.  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s was struck by a tank hatch sometime in the past and suffered back and neck pain.  The neck pain resolved, however what he described as mid-back pain remained.  X-rays on 11 December 2002 showed a normal lumbar spine.  An MRI on 26 December 2002 showed a normal cervical spine.  

During a physical therapy examination on 10 February 2004, 5 months prior to separation, the CI reported LBP with no radiation to lower extremities.  No bladder or bowel problems were noted.  Pain medication was recorded as Motrin with pain intensity at 2/10.  Range of motion (ROM) was reported at 45 degrees flexion (normal 90) and extension at 5 degrees (normal 30).  Each measurement remained unchanged after three repetitions with a bubble goniometer.  

The 19 March 2004 MEB NARSUM examination, 4 months prior to separation, noted complaints of severe mid-back pain.  Motrin and Feldene (non-narcotic, anti-inflammatory) medication were used for pain control.  Pain was reported as slight and constant.  Physical examination referred to physical therapy ROM.  There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5299-5237 (analogous to lumbosacral strain), citing limited thoracolumbar ROM due to pain.  The panel agreed 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 10 February 2004 physical therapy examination, and referenced in the NARSUM examination.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the LBP condition, coded 5299-5237.  

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

The panel 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 Subjective LBP	5299-5237	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150625, w/atchs
Exhibit B.  Service Treatment Record

AR20170019432, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	
Enclosure