RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-00942
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090527

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Infantryman, medically separated for “vertebral fracture, T10 compression” with a disability rating of 10%.  

CI CONTENTION:  “The rating I received didn’t match my disabilities.  I received a 10% for a T10 break in my back, nerve pain and back pain.  When I was discharged from the Army they would only rate me for the fracture.  I had multiple problems with my back including nerve pain.”  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 - 20090318	VARD - 20090626	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Vertebral Fracture, T10 Compression	5235	10%	Vertebral Fracture, T10 Compression	5235	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0% 	

ANALYSIS SUMMARY:  

Vertebral Fracture, T10 Compression.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began in in late 2007 while deployed in Iraq.  The CI was in the back of his Bradley fighting vehicle when the vehicle was traveling at a high rate of speed and hit a fairly steep ravine.  The CI was thrown up against the roof of the vehicle and then fell to the floor.  He had taken off his helmet and hit the roof with his head which developed an axial load on his spine.  A CT scan of the T-spine done in April 2008 showed an old endplate fracture of the T10 vertebral body.  Orthopedic surgery recommended no operative intervention for his condition.  

The 30 January 2009 MEB NARSUM examination, 4 months prior to separation, noted complaints of constant dull, squeezing, cramping, throbbing, agonizing, annoying pain.  There was no radiation.  He reported his pain was a baseline of 1/10 and increased as high a 9/10 during flares.  Physical examination showed a normal gait and tenderness.  There was no muscle spasm or edema.  Thoracolumbar range of motion (ROM) measurements showed flexion of 70 degrees (normal 90) and combined ROM of 150 degrees (normal 240) after repetition.  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the vertebral fracture 10%, coded 5235 (vertebral fracture or dislocation), citing limitation of motion.  The VA rated the vertebral fracture 0%, also coded 5235, based on the STR, citing the absence of a VA examination.  

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/or 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 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 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 vertebral fracture.  

BOARD FINDINGS:  In the matter of the vertebral fracture 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.  

AR20180014701, 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.