RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-00036
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20050430

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Unit Supply Specialist, medically separated for “chronic low back pain” with a disability rating of 0%.  

CI CONTENTION:  “Request for all MEB/PEB conditions to be considered.”  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 PEB, but determined 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.  Furthermore, the panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(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, operating 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 the disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20050104	VARD - 20050927	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5237	0%	Chronic Low Back Pain	5299-5237	NSC	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Low Back Pain (LBP).  According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI had a 3-year history of LBP without specific injury or trauma.  Lumbar spine X-rays were normal and he was not a surgical candidate.  During the 11 August 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 8 months before separation, the CI reported LBP when carrying a load or with prolonged standing.  Physical examination showed a normal spine and the examiner assessed chronic LBP.  The 19 October 2004 MEB NARSUM examination, 6 months prior to separation, noted CI complaints of pain with heavy lifting and prolonged standing, but he denied constant or radiating pain; rest improved symptoms.  Physical examination showed range of motion (ROM) with flexion of 85 degrees (normal 90) and a combined ROM of 220 degrees (normal 240); painful motion with not mentioned.  Straight leg raise (SLR) testing was negative and muscle strength normal.  

At the 24 July 2006 VA Compensation and Pension (C&P) evaluation, 15 months after separation, the CI reported recurrent pain about 10-15 times per month precipitated by prolonged standing and sitting.  Physical examination showed full ROM with painful motion.  There was no weakness, tenderness, guarding, instability, or spasm.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 0%, coded 5237 (lumbar spine strain), citing 85 degrees of flexion with no spasm or radiculopathy.  The VA initially did not service-connect the back condition, analogously coded 5299-5237 (lumbar spine strain), citing no evidence of fractures.  A second VA rating 19 months after separation rated the back at 0% (effective on the date of separation), citing ROM of greater than 85 degrees of flexion.  Members agreed that the ROM recorded at the MEB NARSUM sufficiently supported a 10% rating, but no higher, based on limitation of motion (greater than 60 degrees but not greater than 85 degree; and combined ROM of greater than 120 degrees but not greater than 235 degrees).  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. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the chronic LBP condition, coded 5237.  

BOARD FINDINGS:  In the matter of the chronic LBP condition, the panel unanimously recommends a disability rating of 10%, 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 as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Low Back Pain	5237	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161207, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180003276, 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