RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00848
BRANCH OF SERVICE:  ARMY	SEPARATION DATE:  20051203

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Shower/Laundry and Clothing Repair Specialist, medically separated for “chronic back pain” with a disability rating of 10%.

CI CONTENTION:  His current back condition supports a higher rating.  An additional unfitting headache condition was not 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 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 - 20051025	VARD - 20060324	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain	5299-5242	10%	Lumbosacral Degenerative Disc Disease, with Mild, Central, Posterior Disc Bulge at L5-S1	5242	10%	20060111	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Chronic Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back pain condition began in January 2005 after being tackled while playing football.  X-rays from February 2005 revealed a mild, central, posterior disc bulge of questionable significance at the L5 to S1 level.  On 3 June 2005 an electrodiagnostic study was normal.  There was no surgical indication.  The 27 September 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of pain approximately 75% of the time while awake.  Physical examination showed a non-antalgic gait; spinal tenderness was present, but no spinal muscle spasm.  Spinal contour was not addressed.  Thoracolumbar spine range of motion (ROM) was flexion to 75 degrees (normal 90) and combined ROM was 225 degrees (normal 240); all with painful motion.

At the 11 January 2006 VA Compensation and Pension (C&P) general evaluation, 1 month after separation, the CI reported daily flare-ups associated with sitting, standing, bending, or even touching his back.  Physical examination showed a normal gait and posture, no spinal tenderness, but muscle spasm was present.  Flexion was 70 degrees and combined ROM was incomplete; painful motion was present.  There was no loss of motion with repetition.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back pain condition 10%, analogously coded 5299-5242 (degenerative arthritis of the spine), citing limitation of combined ROM.  The VA also rated the back pain condition 10%, coded 5242, 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 NARSUM and VA examinations.  Although there was muscle spasm, it was not severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified.  There was no evidence of intervertebral disc syndrome which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under the alternate VASRD formula for that condition.  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 pain condition.

BOARD FINDINGS:  In the matter of the back pain 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 20170210, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180004921, 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