RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00780
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20060302

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Ground Surveillance Systems Operator, medically separated for “chronic 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 - 20051215	VARD - 20060616	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5237	10%	Chronic Lumbar Strain	5237	20%	20060508	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in April 2004 after wearing two rucksacks.  He underwent several diagnostic nerve blocks that were unsuccessful in eliminating his pain.  Radiographic studies were essentially unremarkable.  Surgery was not recommended.  During the 11 October 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported persistent back pain.  The physical examination showed tenderness and decreased range of motion (ROM) in the lateral planes.  In physical therapy the same day, flexion was 75 degrees (normal 90) and combined ROM was 155 degrees (normal 240).  

The 2 November 2005 orthopedic addendum to the MEB NARSUM, 4 months prior to separation, noted almost daily back pain aggravated by forward flexion and rotation.  The neurological examination and gait were normal.  Flexion was 70 degrees and combined ROM was 150 degrees.  The 15 November 2005 MEB NARSUM examination, 4 months prior to separation, noted complaints of mid-back pain exacerbated by bending, twisting or lifting heavy weights.  The neurological examination was normal.  There was tenderness at T5-7.  

At the 8 May 2006 VA Compensation and Pension (C&P) evaluation, 2 months after separation, the CI reported ongoing back pain refractory to treatment.  The physical examination showed a normal gait and posture without the use of assistive devices.  The para-spinous musculature was tight and tenderness was present in the right mid-thoracic area.  Flexion was 85 degrees and combined ROM was 165 degrees with pain in the lateral planes and rotation.  The examiner also opined that during flare-ups, the CI might lose an additional 15 degrees of lateral flexion and 10 degrees of rotations in both directions.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5237 (lumbosacral or cervical strain), citing tenderness and limited motion due to pain.  The VA rated the back condition 20%, coded 5237, (lumbosacral or cervical strain), based on the C&P examination, citing a combined ROM of less than 120 degrees during flare-ups.  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) and combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the MEB and MEB addendum examinations.  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 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 20170222, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180004904, 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