RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00777
BRANCH OF SERVICE:  ARMY	SEPARATION DATE:  20070604

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Wheeled Vehicle Mechanic, medically separated for “chronic low back pain” with a disability rating of 0%.

CI CONTENTION:  Current back condition supports a higher rating.  He also requested other conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) be reviewed.  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20070412	VARD - 20080227	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5237	0%	Chronic Back Pain	5237	10%	20080102	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI suffered a spinal fracture in June 2000 prior to enlistment.  Low and middle back pain manifested during basic training with ruck marching and running.  An MRI showed degenerative disc disease in the mid to lower thoracic levels and vertebral body irregularities in the lower thoracic and upper lumbar spine, which were felt to be developmental rather than Schmorl’s nodes.  There was no evidence of focal disc herniation, significant spondylosis or stenosis at any level.  In October 2006, the CI slipped during training and reinjured his back.  X-rays showed a mild T12 and L1 vertebral body compression deformity.

At the 19 March 2007 battalion surgeon examination, 2 months before separation, the goniometric range of motion (ROM) measurements of the thoracolumbar spine showed flexion of 70 degrees (normal 90).  Combined ROM was incomplete and painful motion was not addressed.  The 22 March 2007 MEB NARSUM examination, noted complaints of unrelenting back pain which was stable.  Physical examination, based on DD Form 2808 performed on 21 February 2006, showed a straight spine without obvious deformity.  There was no spinal tenderness and the aforementioned ROM was referenced.

During the 2 January 2008 VA Compensation and Pension (C&P) evaluation, 7 months after separation, the CI reported chronic back pain, aggravated by standing, twisting, lifting or running.  Physical examination showed spinal tenderness.  ROM was flexion to 70 degrees.  Combined ROM was incomplete, but painful motion was present.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the low back condition 0%, coded 5237 (lumbosacral strain), citing no evidence of mechanical block to full range of motion.  The VA rated the low back condition 10%, also coded 5237, based on the C&P examination, citing limitation of flexion.  The panel agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 60 degrees but not greater than 85 degrees), as reported on the examinations proximate to separation.  There was no 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 that alternate VASRD formula.  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 back condition, coded 5237.

BOARD FINDINGS:  In the matter of the back condition, the panel 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 that 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 20170217, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180004902, 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