RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01315
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041006

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Signal Support Systems Specialist, medically separated for “chronic low back pain” with a disability rating of 0%.   

CI CONTENTION:  Review of back injury, depression, anxiety requested.  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 Medical Evaluation Board (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 - 20040806	VARD - 20051102	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5237	0%	Multi-level Degenerative Disc Disease (DDD), L-S Spine	5243	20%	20050817	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain (LBP).  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s LBP condition began as early as June 2003 after a motor vehicle accident, and was exacerbated in January 2004 when she was hit during combative training.  An MRI examination on 29 March 2004, 8 months prior to separation, showed mild degenerative changes at L2-3, L4-5 and L5-S1 without significant foraminal compromise or disc herniation.  

During the 4 May 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported recurrent back pain with numbness and tingling.  Physical examination showed range of motion (ROM) recorded as forward flexion at 80 degrees (normal 90).  The MEB NARSUM examination performed on the same day noted complaints of pain with activity, prolonged standing, heavy lifting, bending, and stooping that resolve with activity limitation.  Physical examination showed no tenderness; flexion was 60 degrees and combined ROM was 190 degrees (normal 240) with painful motion noted. 

At the 17 August 2005 VA Compensation and Pension (C&P) examination, 10 months after separation, the CI reported aching LBP most of the time that became a throbbing sharp pain with increased activity.  When standing, she would get an occasional radiation of pain with numbness and tingling.  Physical examination showed flexion to 40 degrees and combined ROM of 100 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the LBP 0%, coded 5237 (lumbosacral strain), citing normal gait and ROM.  The VA rated the back at 20%, coded 5243 (intervertebral disc syndrome), based on the C&P examination, citing limited ROM.  The panel noted the discrepancy between the MEB and MEB NARSUM examinations which were recorded on the same date.  The later VA examination is consistent with the more limited ROM.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the chronic LBP, coded 5237.  

BOARD FINDINGS:  In the matter of the chronic low back pain, the panel majority recommends a disability rating of 20%, coded 5237 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Low Back Pain	5237	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161003, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180005691, XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,					      
Enclosure