RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00689
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090118

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Petroleum Supply Specialist, medically separated for “low back pain” with a disability rating of 10%.  

CI CONTENTION:  The CI made no specific contention.  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 - 20081020	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbago	5299-5237	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:  

Lumbago.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began in April 2000 during a bad parachute landing fall.  X-rays were planned; however, no details were in the STR.  His pain improved within 1 month of therapy and he was separated from active duty, but re-enlisted in January 2006.  In November 2006, the CI deployed as a tactical fuel vehicle operator.  Repetitive jarring while driving over rough terrain, together with wearing full battle gear, exacerbated his condition.  On 26 February 2008, an MRI showed transitional vertebra at the lumbosacral junction with pseudoarticulation bilaterally of the transverse processes.  During 19 August 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported low back pain (LBP).  Physical examination showed lumbar tenderness.  

The 22 September 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of LBP present for approximately half of the CI’s waking hours.  Pain was described as a dull aching pressure sensation.  Painful flares were associated with stabbing bilateral low back pain, some locking sensation and muscle spasms.  Pain was exacerbated by walking, running, jumping, going up or down stairs, lifting more than 30 pounds, and prolonged sitting or standing.  Physical examination showed tenderness and spasm, but no involuntary guarding.  The CI was able to heel-toe and tandem walk without increased back pain.  Motor strength, reflexes and sensation were normal and straight leg raise testing (to determine nerve root irritation) was negative bilaterally.  Patrick and FABER tests (to evaluate the hip or sacroiliac joint pathology) were also negative.  Range of motion (ROM) measurements of the thoracolumbar spine after three repetitions were forward flexion of 95 degrees (normal 90) and combined ROM of 235 degrees (normal 240).  ROM was noted to be painful.  There was no VA Compensation and Pension examination in evidence proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5299-5237 (lumbosacral strain) citing functional loss and painful motion.  The panel agreed that a 10% rating, but no higher, was justified for the combined ROM (greater than 120 degrees but not greater than 235 degrees) as reported on the NARSUM examination.  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.  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 back condition.   

BOARD FINDINGS:  In the matter of the back condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There were 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 20170214, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180004737, 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