RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01769
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20040505

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Chemical Operations Specialist, medically separated for “chronic subjective low back pain…”with a disability rating of 10%.  

CI CONTENTION:  “Please review all conditions.”  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 - 20040401	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Subjective LBP…	5299-5237	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Subjective Low Back Pain (LBP) without Neurological Abnormality.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was in a motor vehicle accident in 1998 prior to service entry.  The first record of LBP was dated 22 August 2001 when the CI reported several weeks of LBP.  He was treated with medications.  X-rays were ordered but are not in evidence.  X-rays on 21 May 2002 and 8 July 2002 showed evidence of a previous compression fracture of L1 and L2 with degenerative disc disease (DDD) at the T12 and L1 interspaces.  Per the MEB NARSUM, an MRI done on 15 August 2002 showed multilevel DDD without nerve impingement.  The CI was referred to physical therapy, but was not able to return to full duty.  There was no surgical indication.

The 31 December 2003 MEB NARSUM examination, 4 months prior to separation, noted the CI’s inability to run, do sit-ups, march, or lift greater than forty pounds.  He was not able to conduct some maintenance tasks which required strength and flexibility.  The physical examination performed on 20 October 2003 revealed a normal examination except for “apparent decrease sensation to sharp stimulation, right leg greater than left leg.”  During the 11 February 2004 MEB physical therapy examination, the CI reported constant middle back pain.  Goniometric range of motion (ROM) was flexion to 90 degrees (normal); combined ROM was not addressed.  Painful motion was present.  There was no VA examination proximate to separation in evidence for the panel to review.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the LBP condition 10%, analogously coded 5299-5237 (lumbosacral strain), citing pain-limited ROM.  The panel agreed there was no limitation of thoracolumbar spine motion to support a 10% rating under the General Rating Formula for Diseases and Injuries of the Spine; however the MEB NARSUM examination noted the presence of painful motion to support a 10% rating IAW VASRD §4.59.  There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis.  There was no documentation of intervertebral disc syndrome with incapacitating episodes which would provide for a higher rating under that formula.  Additionally, the panel noted there was no objective evidence of a radiculopathy with functional impairments (such as weakness), nor performance-based evidence from the record that this condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, considering all of 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 LBP condition.

BOARD FINDINGS:  In the matter of the LBP 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 20161113, w/atchs
Exhibit B.  Service Treatment Record

AR20180003802, 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,					      
Enclosure