RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01938
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20030116

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Helicopter Repairer, medically separated for “chronic low back pain without neurological abnormalities” with a disability rating of 10%.

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 – 20021223	VARD - 20030114	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain…	5299-5295	10%	Degenerative Disc Disease	5292-5293	20%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Low Back Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s back condition began in 1999 after lifting heavy equipment onto a helicopter.  His painful back symptoms were treated conservatively and remained intermittent for the next 2 years.  Radiologic studies performed in 2001 revealed degenerative-arthritic changes about the lumbosacral spine without nerve root compression.  He was not a surgical candidate.

At the MEB NARSUM examination on 16 December 2002, less than 1 month before separation, the CI reported low back pain with normal daily activities and occasional numbness in the right foot.  Physical examination revealed decreased thoracolumbar range of motion (ROM) of flexion to 40 degrees, extension to 20 degrees, and normal lateral flexion, bilaterally.  Spinal tenderness was not present.  Lower extremity strength and sensation were normal.

There was no VA Compensation and Pension examination performed for this panel to review.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back pain condition 10%, analogously coded 5299-5295 (lumbosacral strain), citing painful motion IAW DoDI 1332.39 and AR 635-40.  The VA rated the back pain condition 20% analogously coded 5292-5293 (intervertebral disc syndrome), based on radiographic evidence from the STR indicating degenerative joint disease.

In accordance with DoDI 6040.44, the panel is required to recommend a rating IAW the VASRD in effect at the time of separation which was the 2002 VASRD.

The panel agreed there was no intervertebral disc syndrome of recurring attacks, or muscle spasm on forward bending or listing of the whole spine to support a higher rating with VASRD code 5293 or 5295.  However, there was limitation of spinal motion which could be rated at “moderate” 20% or “severe” 30% to support a higher rating with code 5292.  The panel agreed that the 40 degrees of flexion documented by the MEB NARSUM ROM examination, less than 1 month before separation, supported a “moderate” 20% rating.  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 low back pain condition, coded 5292.

BOARD FINDINGS:  In the matter of the chronic low back pain condition, the panel unanimously recommends a disability rating of 20%, coded 5292 IAW VASRD §4.71a.  There were 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 Low Back Pain	5292	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150714, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170010006, 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 to 20% 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