RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02263
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20061023

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Aircraft Structural Repairer, medically separated for low back pain (LBP) and “chronic left knee pain,” rated 0% and 0% respectively, with a combined disability rating of 0%.  

CI CONTENTION:  “Review all conditions.”  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited 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.  Any conditions outside the Board’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 Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations 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 at the time of separation. The Board 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 Board 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 - 20060908	VARD - 20070823	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Non-Radiating Low Back Pain	5237	0%	Sacralization of the Lumbar at L5 with DDD…	5237	NSC	STR	
Chronic Left Knee Pain	5099-5003	0%	Left Knee Condition	5260			
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

LBP.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s LBP condition had troubled him for approximately 6 years without specific injury or trauma.  A magnetic resonance imaging (MRI) study of the lumbar spine showed a disk protrusion at L1-L2 and L5-S1 with moderate degenerative changes.  He was not a surgical candidate.  

The 27 July 2006 MEB NARSUM examination on, 3 months prior to separation, noted complaints of back pain aggravated by marching and performing parachute jumping.  
The physical examination showed “a nearly full” range of motion (ROM), and absence of muscle spasms.  There was no evidence of radiculopathy, and pain was not present.  The CI did not report for the 5 April 2007 VA Compensation and Pension (C&P) evaluation.  

The panel directed attention to its rating recommendation based on the above evidence.  

The PEB rated the back condition 0%, coded 5237 (lumbosacral strain), citing full motion and no detection of tenderness and muscle spasm.  

There was no limitation of thoracolumbar spine motion to support a minimum rating under the General Rating Formula for Diseases and Injuries of the Spine and the MEB examination did not note the presence of painful motion, muscle spasm, guarding or localized tenderness.  There was no history or evidence of vertebral body fracture with loss of 50 percent or more of the height, nor was there evidence of additional functional loss that would impact functioning in the average civil occupation.  

After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the LBP condition.  

Left Knee Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s knee condition began in June 2004 after sustaining a fracture of the left tibia and fibula.  The fracture was treated with rods and transfixed screws.  

The 27 July 2006 MEB NARSUM examination, 3 months prior to separation, noted complaints of leg pain.  The CI complained of periods where his knee gave out causing him to fall down the stairs.  The physical examination showed some decreased sensation about the knee medial to the scar and above the patella, but no swelling.  He was able to heel and toe walking without any difficulty and ROM was not recorded.  The CI did not report for the 5 April 2007 VA Compensation and Pension (C&P) evaluation.  

The panel directed attention to its rating recommendation based on the above evidence.  

The PEB rated the left knee condition 0%, analogously coded 5099-5003 (degenerative arthritis), citing full motion, no effusion and good stability.  

There was no evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There likewise was no limitation of motion which attained a minimum rating under the diagnostic codes for limitation of flexion or extension (5260, 5261).  The examinations proximate to separation did not demonstrate the presence of ligamentous instability or laxity (5257), and there was no history of dislocated meniscus or loose body causing frequent locking with recurrent effusions (5258), or history of surgery to remove a meniscus (5259) to support a rating under the respective codes.  

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 left knee condition.  

BOARD FINDINGS: In the matter of the LBP condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  

In the matter of the left knee condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  

There are 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 20150715, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170012161, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

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,