RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-01198
BRANCH OF SERVICE:  Air force 	SEPARATION DATE:  20090109

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Vehicle & Vehicular Equipment Maintenance Apprentice, medically separated for “degenerative disc disease [of the back]” with a disability rating of 0%.

CI CONTENTION:  “I feel that my rating is a little low due to the fact that it still affects my quality of life and I still have to manage the 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 - 20081120	VARD - 20091013	
Condition	Code	Rating	Condition	Code	Rating	Exam	
DDD of the Back	5242	0%	Thoracolumbar Degenerative Disease	5243	10%	20090918	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Degenerative Disc Disease (DDD) of the Back.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was first seen for low back pain (LBP) in October 2006 while attending basic training.  He reported a 2-year pre-service history of LBP from playing football.  A CT scan showed degenerative joint disease of the lower back and an MRI revealed DDD at L3-4.  

At the 27 August 2008 physical therapy examination, 5 months prior to separation, the CI reported intermittent radiating pain in the lower extremities.  Range of motion (ROM) testing showed forward flexion of 90 degrees (normal) and combined thoracolumbar ROM of 230 degrees (normal 240).  Painful motion was not recorded and gait was normal.  The 17 September 2008 MEB NARSUM physical examination, 4 months prior to separation, showed no tenderness or muscle spasm.  Provocative testing for nerve root irritation was negative.  The gait, neurological examination, and lumbosacral ROM were normal.  

During the 18 September 2009 VA Compensation and Pension (C&P) evaluation, 8 months after separation, the CI denied stiffness, fatigue, spasms, or numbness, but endorsed leg weakness.  Back pain was exacerbated with physical activity.  The physical examination showed no radiating pain on movement.  Tenderness, guarding, and muscle spasms were present, but gait and spinal contour were normal.  Straight leg raise testing was negative and there was no ankylosis.  ROM testing showed flexion at 80 degrees with pain beginning at 70 degrees and combined ROM of 230 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 0%, coded 5242 (degenerative arthritis of the spine), in accordance with DoD and VASRD guidelines.  The VA rated the back condition 10%, coded 5243 (intervertebral disc syndrome), based on the C&P examination, citing limited motion.  The NARSUM and VA examinations supported a 10% rating for limited motion.  There was no spasm or guarding causing altered gait or spinal contour to support a rating higher than 10%.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the back condition, coded 5242.  

BOARD FINDINGS: In the matter of the back condition, the panel recommends a disability rating of 10%, coded 5242 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	
Degenerative Disc Disease of the Back	5242	10%	

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

Dear XXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-01198.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was not appropriate under the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended modification of your assigned disability rating without re-characterization of your separation with severance pay. 

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding, accept their recommendation and direct that your records be corrected as set forth in the attached copy of a Memorandum for the Chief of Staff, United States Air Force.  This will not result in any change to your separation documents or the amount of severance pay you are entitled to.  Disability severance pay is computed the same regardless of a rating of 0, 10 or 20 percent.