RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-01025 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20060415

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Mortarman, medically separated for “lumbago” with a disability rating of 10%.

CI CONTENTION: The lower back condition still has issues. The CI also requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 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 - 20060206	VARD - 20060728	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbago	5243	10%	Degenerative Joint Disease, Lumbar Spine	5242	10%	20060228	
Chronic Sacroiliitis	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Lumbago. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began during high school. After entering active service with a subsequent deployment to Iraq, he began having back pain and was seen for it in September 2004. MRI of lumbar spine from February 2005 showed mild annular bulge at L5-S1 and some narrowing felt to be consistent with a mild herniated nucleus pulposus.  There was no surgical indication.

The 28 October 2005 MEB NARSUM examination, 6 months prior to separation, noted complaints of intermittent pain that was worse with certain movements of the torso, sleeping on his back, and with heavy lifting. He had not been able to run since March of 2005. Physical examination showed no obvious scoliosis or deformities of the thoracolumbar spine. There was tenderness present. Range of motion (ROM) measurements showed flexion of 90 degrees (normal), 20 degrees of extension with pain and 30 degrees of rightward and leftward flexion of the upper torso. At the 28 February 2006 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported intermittent pain, happening about twice per day and lasting

up to one hour. The pain was achy and sharp with an intensity of 4/10. Physical examination showed a normal gait. ROM measurements were flexion of 70 degrees and combined ROM of 185 degrees.  Tenderness, spasm and painful motion were present.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the lumbago condition 10%, coded 5243 (intervertebral disc syndrome [IVDS]), citing the condition existed prior to service with a 0% reduction. The PEB also listed chronic sacroiliitis as a related Category II condition that contributed to the primary unfitting condition but was not separately ratable. The impairment from the chronic sacroiliitis was properly subsumed under the overall rating for the lumbago IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The VA also rated the back condition 10%, coded 5242 (degenerative arthritis of the spine), based on the C&P examination, citing combined ROM of 175 degrees.

The panel agreed a 10% rating was justified for the presence of painful motion and tenderness, as reported on both the NARSUM and C&P examinations. The panel agreed that a 10% rating, but no higher, was equally 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 VA examination. Although there was muscle spasm reported on the C&P examination, it was not 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 concluded there was insufficient cause to recommend a change in the PEB adjudication for the lumbago condition.

BOARD FINDINGS: In the matter of the lumbago 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.

2	PD-2017-01025

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN   REPLY   REFER  TO,
1850
CORB: 003 20May20

From: 

Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW  (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 29 Oct 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate  action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation  Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.