RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXX	CASE: PD-2017-01368
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20090115

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Senior EOD Technician, medically separated for “intervertebral disc syndrome” with a disability rating of 10%.

CI CONTENTION: In addition to the back condition, 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’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 - 20081022	VARD - 20090909	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Intervertebral Disc Syndrome	5243	10%	
Intervertebral Disc Syndrome of the Lumbar Spine	
5243	
10%	
20090420	
Chronic Low Back Pain	Cat II					
Lumbar Spondylosis	Cat II					
L4-5 Disc Bulge	Cat II					
L5/S1 Disc Protrusion	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Intervertebral Disc Syndrome. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in 2005. An MRI in January 2008 revealed a disc herniation at L5-S1, superimposed on a diffuse disc bulge and mild diffuse spondylosis. Mild foraminal stenosis was present.     X-rays in January 2008 showed an apex right curvature of the

thoracolumbar spine with disc height loss at L5-S1 and mild retrolisthesis of L4 on L5 and straightening of the lumbar spine, which could be associated with muscle spasm.

The 24 March 2008 MEB NARSUM examination, 10 months prior to separation, noted complaints of 2-6/10 low back pain that worsened with prolonged standing or sitting, moderate to heavy lifting and running. The CI reported that running produced spasms in the low back and he had intermittent right leg pain, which occurred approximately four times out of the last six months. He had no bowel or bladder symptoms nor numbness or tingling in the extremities. Physical examination showed a normal gait. There was mild tenderness in the left paraspinal muscular region and no scoliosis. Sensation was intact to light touch and deep tendon reflexes were trace at the patella and 1+ at the bilateral ankles. Straight leg raise (SLR) testing was negative. Thoracolumbar range of motion (ROM) testing showed flexion of 90 degrees (normal) and combined ROM of 240 degrees (normal) with pain. Thoracolumbar ROM measurements performed by physical therapy (PT) on 3 September 2008, 4 months prior to separation, showed flexion of 90 degrees and combined ROM of 225 degrees after repetition. Terminal ROM in all directions of movement was limited by pain.

At the 20 April 2009 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported 1-6/10 back pain associated with stiffness and there were intermittent flare-ups caused by physical activity and stress. Physical examination showed normal gait and posture. There was tenderness of the right paraspinal muscles. SLR testing was negative bilaterally. Thoracolumbar spine ROM was normal and not limited by repetitive use, pain, fatigue, weakness, lack of endurance or incoordination. Motor function and sensory examinations were normal.  Lumbar spine X-rays were normal.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the back condition 10%, coded 5243 (intervertebral disc syndrome). The Navy PEB also listed chronic low back pain, lumbar spondylosis, L4-5 disc bulge and L5/S1 disc protrusion as related Category II conditions (contributed to the primary unfitting condition but were not separately ratable). The impairment from the Category II conditions was properly subsumed under the overall rating for the back condition IAW §4.14 (avoidance of pyramiding). The VA also rated the back condition 10%, coded 5243, based on the C&P examination, citing objective findings of tenderness without evidence of abnormal spinal contour or abnormal gait.

The panel agreed that a 10% rating, but no higher, was justified for limitation of combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the PT examination proximate to separation. 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 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 concluded there was insufficient cause to recommend a change in the PEB adjudication for the back condition.

BOARD FINDINGS: In the matter of the back 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.

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 Mar 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.