RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02315
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20080502

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Aerospace Ground Equipment Journeyman, medically separated for “ankylosing spondylitis” with a disability rating of 10%.

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 - 20080222	VARD - 20080815	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Ankylosing Spondylitis	5240	10%	Lumbosacral Spine Ankylosing Spondylitis	5240	0%	20080612	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Ankylosing Spondylitis.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI lower back pain condition began in 2005 after long-distant runs.  He was treated by orthopedics and physical therapy without resolution.  In April 2007 a rheumatologic work-up revealed an HLA-B27 antigen (associated with autoimmune diseases such as inflammation of the spine).  He was diagnosed with ankylosing spondylitis with no surgical indication.  Due to the CI being chronically treated with an immunosuppressant medication the MEB forwarded ankylosing spondylitis for PEB adjudication.

The MEB NARSUM examination on 7 December 2007 (5 months prior to separation) noted complaints of low back pain had resolved with rest and treatment.  Physical examination showed no spinal tenderness.  Physical examination was performed by rheumatology on 07 January 2008 (4 months prior to separation) that revealed full flexion; painful motion was not addressed.  An MRI of the pelvis dated 13 November 2006 (18 months prior to separation) noted bilateral sacroiliitis (left worse than right).  As mentioned above, a 24 April 2007 (13 months prior to separation) rheumatologic evaluation with laboratory test was positive for the HLA-B27 antigen.  

At the 12 June 2008 VA Compensation and Pension (C&P) evaluation, performed 1 month after separation, the CI reported that his back pain had resolved as a result of treatment and that he had no functional impairment at that time.  Physical examination showed normal range of motion of the thoracolumbar spine that was not limited by repetitive use, pain, fatigue, weakness, lack of endurance or incoordination.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the ankylosing spondylitis 10%, coded 5240 (ankylosing spondylitis).  The VA rated the ankylosing spondylitis 0%, also coded 5240 based on the C&P examination 1 month after separation, citing full and painless limited motion.  The Board agreed there was no limitation of spinal motion to support the minimum 10% rating.  The MEB NARSUM and VA C&P examinations did not note the presence of painful motion, muscle spasm, guarding, localized tenderness or functional loss.  There was no history or evidence of vertebral body fracture with loss of 50 percent or more of the height.  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 ankylosing spondylitis.

BOARD FINDINGS:  In the matter of the ankylosing spondylitis and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  The Board, 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 20150903, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-02315.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  The Board recommended no re-characterization or modification of your separation.

I carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  I accept their recommendation that your application be denied.

							Sincerely,

XXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings