RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00843
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050407

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, M1 Abrams Tank System Mechanic, medically separated from the Temporary Disability Retired List (TDRL) for “chronic low back pain” with a disability rating of 0%.

CI CONTENTION:  “Still haven’t recovered.”  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 - 20050324	VARD - 20040220	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5243	0%	Lumbar Spine Degenerative Disc Disease	5242	10%	20031201	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS: 50%	

ANALYSIS SUMMARY:

Chronic Low Back Pain.  According to the 8 September 2003 MEB NARSUM addendum, 19 months prior to TDRL removal, the CI had suffered chronic back pain since 2000.  A lumbar spine MRI showed an L5-S1 bulging disc which caused nerve root compression, and the examining neurosurgeon did not recommend surgical intervention.  Physical examination showed a normal gait and spine alignment without muscle spasm, but some local tenderness.  Thoracolumbar range of motion (ROM) was “full,” with painful motion, but testing for radiculopathy was negative.  Reflexes were normal and there was altered sensation about the left foot.  
At the 1 December 2003 VA Compensation & Pension (C&P) examination, 17 months before separation, the CI reported back pain with heavy lifting or prolonged sitting, and left leg numbness.  Physical examination revealed a normal gait and posture, and no spinal tenderness; muscle spasm was not addressed.  Thoracolumbar spine flexion was 90 degrees (normal) and combined ROM was incomplete; painful motion was elicited.  The CI was separated and placed on the TDRL on 4 February 2004.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 0%, coded 5243 (intervertebral disc syndrome (IVDS)), citing full ROM, no tenderness, and no signs of radiculopathy.  The VA rated the back condition 10%, based on the remote C&P examination, citing painful motion.  Although there was insufficient limitation of motion to support a 10% rating, the panel agreed that a 10% rating was justified based on painful motion as recorded on the available MEB NARSUM and VA 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 IVDS with incapacitating episodes which would provide for a higher rating under that formula.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the low back condition, coded 5243.

BOARD FINDINGS:  In the matter of the chronic low back pain, the panel recommends a disability rating of 10%, coded 5243 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.

Therefore, the panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Low Back Pain	5243	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170420, w/atchs 
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180010342, 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