RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX		CASE: PD-2017-01186 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20050418

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was a National Guard E5, Radio Repairer, medically separated for “chronic low back pain” with a disability rating of 10%.

CI CONTENTION:  Review all conditions.  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 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 - 20050218	VARD - 20061208	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5239	10%	Chronic Lumbar Strain	5242	10%	20060510	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Chronic Low Back Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI sustained an injury in 1996 during basic training when she was in the Navy. An MRI showed a large central disc protrusion at L5-S1 with Grade I spondylolysis. The 1 December 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, revealed tenderness  and  decreased  range  of  motion  (ROM)  to  “45%  flexion.”  During  the 23 December 2004 MEB NARSUM examination, 4 months prior to separation, the CI complained of increasing back pain with activity and carrying heavy loads. Physical examination showed no limp or active muscle spasms. The ROM study showed flexion of 50 degrees (normal 90) and combined ROM of 130 degrees (normal 240). At the 30 March 2005 neurosurgery examination, 1 month prior to separation, thoracolumbar ROM measurements showed flexion of 40 degrees and combined ROM of 120 degrees, after repetition.

At the 10 May 2006 VA Compensation and Pension (C&P) examination, 13 months after separation, the CI reported low back pain. The examiner found a normal gait. The ROM evaluation showed flexion of 90 degrees and combined ROM of 240 degrees without pain or

discomfort in any plane of movement. On repetitive flexion, there were no signs of fatigability or changes in the lower back.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the back condition 10%, coded 5239 (spondylolisthesis or segmental instability), citing no radiculopathy, muscle spasm or tenderness, and ROM was essentially normal. The VA also rated the back condition 10%, coded 5242 (degenerative arthritis of the spine), based on the C&P examination, citing forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees. The panel agreed that a 20% rating, but no higher, was justified for limitation of flexion greater than 30 degrees but not greater than 60 degrees, as reported on the NARSUM and neurosurgery examinations most proximate to separation. 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 the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the back condition, coded 5239.

BOARD FINDINGS: In the matter of the back condition, the panel recommends a disability rating of 20%, coded 5239 IAW VASRD §4.71a. There are no other conditions within the panel’s scope of review for consideration.

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	5239	20%	

XXXXXXXXXXXXXX

Dear XXXXXXXXXXXX

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.