RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE: pd-2015-02425
BRANCH OF SERVICE:  navy	SEPARATION DATE:  20070914

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E5, Construction Electrician, medically separated for “ankylosing spondylitis” with a disability rating of 20%.

CI CONTENTION:  Evidence from 2007 supports a higher rating.  The CI requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the MEB, but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:

SERVICE PEB - 20070706	VARD - 20070915	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Ankylosing Spondylitis	5240	20%	Ankylosing Spondylitis…	5240	20%	20070702	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Ankylosing Spondylitis.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began in October 2006 while performing heavy shoveling and cement work while deployed to Iraq.  X-rays showed severe ankylosing spondylitis (inflammatory arthritis of the spine and large joints).  Subsequent rheumatology evaluations revealed the CI’s back condition was inherited.  

During the 2 May 2007 rheumatology evaluation, 5 months prior to separation, the CI reported low back pain which radiated to the buttocks.  Physical examination revealed abnormal lordosis (inward curvature at lower back) and spinal tenderness.  Range of motion (ROM) was normal and painful motion was not present.  Gait and muscle spasm were not addressed.  At the 7 May 2007 physical therapy evaluation, 4 months before separation, the CI reported no low back pain.  Physical examination revealed spinal tenderness with flexion decreased by 30% (approximately 60 degrees (normal 90)); combined ROM was approximately 150 degrees (normal 240); painful motion was not addressed.  The 4 June 2007 MEB NARSUM examination, 3 months prior to separation, noted complaints of costochondral joint pain (pain where the ribs connect to the sternum).  Physical examination showed spinal tenderness.  Gait, posture, muscle spasm, ROM, and painful motion were not addressed.  

During the 2 July 2007 VA Compensation and Pension (C&P) general examination, 2 months before separation, the CI reported chronic low back pain.  Physical examination showed a normal gait and posture and no spinal muscle spasms.  Lower extremity motor strength was 5/5 and sensation was intact.  ROM included flexion to 60 degrees and combined ROM of 195 degrees; painful motion was elicited with repetition.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the ankylosing spondylitis condition 20%, coded 5240 (ankylosing spondylitis).  The VA rated the ankylosing spondylitis condition 20%, also coded 5240, based on the C&P examination, citing limitation of flexion.  The panel agreed a 20% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 60 degrees), as recorded by the physical therapy and VA examinations proximate to separation.  There was no documentation of intervertebral disc syndrome with incapacitating episodes which would provide for a higher rating under that formula.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the ankylosing spondylitis condition.

BOARD FINDINGS:  In the matter of the ankylosing spondylitis 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.  Therefore, the panel recommends 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 20151008 w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44

      In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC

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	     				                        Acting