RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02331
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20020510

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Medical Materiel Helper, medically separated for “chronic low back pain” with a disability rating of 10%.

CI CONTENTION:  The CI requested a review of 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 - 20020313	VARD - 20021223	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain…	5293	10%	Degenerative Lumbar Disk Disease, Lumbar Spine with Grade 1 Spondylolisthesis	5010-5293	20%	20021113	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s chronic low back pain condition began in October 2001 after falling against the edge of a bathtub.  The MEB forwarded “spondylosis” for PEB adjudication.  The MEB NARSUM examination in February 2002, 3 months prior to separation, noted complaints of constant, dull aching lower back pain radiating into the back and sides of both legs.  The CI experienced numbness and tingling with slight loss of strength in the right leg and foot.  She stated that she was unable to do heavy lifting, bending, or prolonged sitting without experiencing significant discomfort and was awakened at night by the pain.  Physical examination showed full range of motion (ROM) with lumbar pain at flexion.  There was a positive straight leg raise elicited and painful motion noted with resisted extension.  The examiner observed the CI walked with an antalgic gait, stiff but without a limp.  At the 13 November 2002 VA Compensation and Pension (C&P) evaluation, performed 6 months after separation, the CI reported taking Motrin for back pain.  Physical examination demonstrated pain at flexion of 80 degrees and lateral deviation to both sides at 18 degrees.  Straight leg raising testing was positive on the right and questionable on the left.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic low back pain condition 10%, coded 5293 (intervertebral disc syndrome), citing DOD and VASRD guidelines.  The VA rated the chronic low back pain condition 20%, coded 5010-5293 (arthritis, due to trauma analogous to intervertebral disk syndrome) based on the C&P examination 6 months after separation, citing recurring attacks of intervertebral disk syndrome.  The Board considered whether the CI’s condition met criteria for rating under diagnostic code 5293.  There was no evidence of recurring emergency department visits for intervertebral disk syndrome pain symptoms.  The Board also noted that the CI used over the counter nonsteroidal medications for pain as needed.  Board member agreed that the evidence supports a rating of 10% for mild intervertebral disk disease and lumbosacral strain with characteristic pain on motion.  There was no evidence of an associated unfitting radiculopathy for consideration of a separate peripheral nerve rating.  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 “chronic low back pain, secondary to spondylosis and disk disease” condition.  

BOARD FINDINGS:  In the matter of the “chronic low back pain, secondary to spondylosis and disk disease” condition and IAW VASRD §4.71a, the Board unanimously or majority 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 20150911, w/atchs
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-2015-02331.

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