RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01658
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050620

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

CI CONTENTION:  No specific contention was made.  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 - 20050425	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5242	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:

Chronic Low Back Pain (LBP).  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s low back condition began acutely in 1999 and again in 2001 after weight lifting, and improved with treatment each time.  However, in September 2002 during a deployment, his vehicle was hit and he began experiencing persistent LBP.  An MRI on 9 March 2004 showed L4-5 and L5-S1 degenerative discs with minimal L4-5 and L3-4 spinal stenosis (narrowing of the spinal canal).

During the 30 March 2004 MEB examination (recorded on DD Forms 2807-1 and 2808), 15 months prior to separation, the CI reported LBP and the provider noted spinal tenderness.  Thoracolumbar range of motion (ROM) was flexion to 90 degrees (normal) and combined ROM to 230 degrees (normal 240); painful motion was not addressed.  

At a primary care visit on 20 December 2004, 6 months before separation, the CI complained of persistent LBP aggravated by activity.  Physical examination revealed degenerative disc disease with bulging disc, but the CI was not a surgical candidate.  During a follow-up examination on 7 January 2005, the CI reported chronic LBP and the surgeon noted normal electrodiagnostic studies and minimal L4-5 and L5-S1 spinal stenosis.  

The 12 April 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of chronic LBP, and the provider documented spinal tenderness and flexion to 90 degrees with a combined ROM of 225 degrees; painful motion was not addressed.  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 LBP condition 10%, analogously coded 5299-5242 (degenerative arthritis of the spine), citing combined limitation of motion and spinal tenderness.  Members 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 MEB NARSUM examination proximate to separation.  There was no evidence of muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, or intervertebral disc syndrome with incapacitating episodes to support a higher rating.  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 low back condition.

BOARD FINDINGS:  In the matter of the chronic low back pain 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.

The following documentary evidence was considered:  

Exhibit A.  DD Form 294, dated 20170306, w/atchs  
Exhibit B.  Service Treatment Record  
Exhibit C.  Department of Veterans Affairs Record  

AR20180010717, 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.

Sincerely,					      
Enclosure