RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01671
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090513

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Calvary Scout, medically separated for “chronic multilevel thoracic/lumbar degenerative disc diseases [DDD]” with a disability rating of 10%.

CI CONTENTION:  The CI requested review of 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 -20090122	VARD - 20090528	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Multilevel Thoracic/Lumbar DDD 	5243	10%	Scheuermann’s Kyphosis	5243	10%	20090311	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Chronic Multilevel Thoracic/Lumbar DDD.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in December 2005 during pre-mobilization training.  X-rays obtained in March 2008 revealed mild T12-L1 arthritis and an L1 compression fracture.  Orthopedic and neurosurgery evaluated the CI and no surgical intervention was recommend.  Despite physical therapy, restrictive profiles and medications, the CI continued to have back pain.

The 10 November 2008 MEB NARSUM examination, 6 months prior to separation, revealed tenderness, but the CI had normal gait and spinal contour and there was no muscle spasm.  Thoracolumbar spine goniometric-measured range of motion (ROM) was flexion to 85 degrees (normal 90) and combined ROM of 155 degrees (normal 240); painful motion was present.

At the 11 March 2009 VA Compensation and Pension (C&P) examination, 2 months prior to separation, the CI reported constant low back pain with occasional flares.  Physical examination revealed spinal tenderness and spasms, but the gait and spinal contour were normal.  Thoracolumbar flexion was 90 degrees and combined ROM was 185 degrees; painful motion was present.  

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 (IVDS)), citing painful and limited motion.  The VA rated the back condition 10%, coded 5243, based on the C&P examination, citing limitation of combined ROM.  The panel agreed that a 10% rating, but no higher, was justified for combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported by the MEB NARSUM and VA examinations 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 IVDS with incapacitating episodes which would provide for a higher rating under that formula.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB’s adjudication of the back condition.  

BOARD FINDINGS:  In the matter of the back condition and IAW VASRD §4.71.a, 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 20170302, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180008157, 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