RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01979
BRANCH OF SERVICE:  Army	SEPARATION DATE: 20051228

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a National Guard E-5, Civil Affairs, separated for “chronic radiating low back pain” with a disability rating of 10%.

CI CONTENTION:  Contends her unfitting low back, hips, neck and systemic arthritis 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 - 20051209	VARD - 20050503	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Radiating Low Back Pain	5237	10%	Low Back Strain	5237	10%	20050113	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Chronic Radiating Low Back Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s low back pain (LBP) condition began in October 2003 during an Iraq deployment when an improvised explosive device  detonated next to the military vehicle in which she was riding, resulting in her being thrown about the vehicle.  Plain X-rays of the lumbar spine taken in May 2004 were unremarkable for any significant abnormality.

At a 13 January 2005 VA Compensation and Pension (C&P) evaluation, 11 months before separation, the CI reported radiating back pain into her buttock 1 day per month with a duration of 1 day.  She reported that her condition did not affect her activities of daily living, although prolonged driving and standing aggravated the painful condition.  The spinal physical examination was completely normal excepting a 10 degree deficit in thoracolumbar extension with a resulting combined ROM of 230 degrees (normal = 240).  Her spine was well aligned and her gait was normal.

At the 26 October 2005 MEB Orthopedic NARSUM examination, 2 months prior to separation, the CI complained of LBP aggravated by prolonged sitting or standing as well as the wearing of a police officers’ heavy belt.  The examiner noted under ‘History of Present Illness’ that “The [CI] is able to do her job, but experienced pain with any increase in activity level.”  Her pain was described as slight and occasional.  The physical examination was normal except for tenderness over both sacral-iliac (SI) joints.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the low back condition 10%, coded 5237 (lumbosacral strain), citing spinal tenderness.  The VA also rated the low back condition 10%, also coded 5237, based on the C&P examination 11 months before separation, citing continued muscle stiffness with slight decrease in extension.  Although there was insufficient limitation of motion to support a minimum rating, the panel agreed a 10% rating was justified for the presence of tenderness as documented on the MEB examination most proximate to separation.  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 documentation of intervertebral disc syndrome (IVDS) with incapacitating episodes which would provide for a higher rating under that formula (for IVDS), or evidence of ratable peripheral nerve impairment which would provide for additional rating.  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’s adjudication for the low back pain condition.

BOARD FINDINGS:  In the matter of the low back pain 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 modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150708 w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170010107, XXXXXXXXXXXXXXXXXX

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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,