[AR Number], XXXXXXXXXXXXXX. 

XXXXXXXXXXXXXXXX
XXXXXXXXXXXXXX
XXXXXXXXXXXX

Dear  XXXXXXX:

	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.
 
	A copy of this decision has been provided to the counsel you listed on your application; [name and address].

Sincerely,					      
						      					
Enclosure

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXX.	CASE:  PD-2016-01794
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040206

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty O-3, Field Artillery Officer, medically separated for “chronic back pain” with a disability rating of 10%.  

CI CONTENTION:  No specific contention was made.  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 - 20031022	VARD - 20040317	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain	5299-5276	10%	Lumbar Degenerative Disc Disease 	5243	10%	20031111	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s low back pain began as early as May 2002 with no specific injury or trauma identified.  Radiographic studies in November 2002 identified multi-level degenerative changes in the lower back.  During the 1 July 2003 physical medicine & rehabilitation examination, 7 months prior to separation, the CI reported low back pain that prevented running, marching, and sit-ups.  Physical examination showed back tenderness, with range of motion (ROM) recorded as flexion to 90 degrees (normal), extension to 20 degrees (normal 30), and lateral flexion to 30 degrees bilaterally (normal 30).  Neurologic examination was normal.

At the 10 September 2003 physical therapy appointment, 5 months before separation, ROM was recorded as flexion to 80 degrees and combined ROM to 175 (normal 240). The 13 September 2003 MEB NARSUM examination noted CI complaints of chronic low back pain. Physical examination showed back tenderness but no muscle spasms.

At the 11 November 2003 VA Compensation and Pension (C&P) examination, 3 months prior to separation, the CI reported shooting back pain rated at 8/10 in severity which did not cause incapacitation.  Physical examination showed a normal gait and posture and an absence of muscle spasm and tenderness.  The examiner recorded flexion to 90 degrees and combined ROM was 240 degrees, with painful motion.  Neurologic examination was within normal limits.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated back condition 10%, coded 5299-5276 (analogous to acquired flatfoot).  The panel surmised that this diagnostic code was a likely typographical error on the PEB report.  The VA also rated the back condition 10%, but coded 5243 (intervertebral disc syndrome), based on the C&P examination.  Members agreed although there was insufficient limitation of motion to support a 10% rating, a 10% rating was justified for the presence of painful motion and tenderness.  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 evidence of intervertebral disc syndrome which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under the alternate VASRD formula for that condition.  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 chronic back pain.  

BOARD FINDINGS: In the matter of the chronic back pain 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 20161121, w/atchs
Exhibit B.  Service Treatment Record