RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01819
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20080721

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Military Policeman, medically separated for “chronic low back pain” with a disability rating of 20%.

CI CONTENTION:  In addition to the back condition, the CI also requested review of an additional condition 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 - 20080407 	VARD - 20081210	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5242	20%	Chronic Lumbosacral Strain 	5237	10%	20081031	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:

Chronic Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in March 2007 while deployed.  The CI was assisting his interpreter to safety when he felt severe lower back pain.  A lumbosacral MRI showed degenerative disc disease with bulging discs.

The 6 March 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of chronic-constant low and middle back pain that occasionally radiated to the right leg.  Physical examination showed a normal gait without spasm, but there was tenderness.  Thoracolumbar range of motion (ROM) testing performed on 7 January 2008, 7 months before separation, showed flexion to 90 degrees (normal) and combined ROM of 240 degrees (normal).  However, the 12 March 2008 MEB physical therapy (PT) examination, 4 months prior to separation, recorded repetitive flexion to 45 degrees and combined ROM of 150 degrees.  Painful motion was elicited.  

At the 31 October 2008 Compensation and Pension (C&P) examination, 3 months after separation, the CI reported back stiffness and pain.  He denied fatigue, weakness or lack of endurance.  Physical examination revealed a normal gait and spinal contour without muscle spasm.  The ROM study showed thoracolumbar flexion of 90 degrees and combined ROM of 240 degrees.  Painful motion was present.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, analogously coded 5299-5242 (degenerative arthritis of the spine), citing limitation of flexion to 45 degrees.  The VA rated the back condition 10%, coded 5237 (lumbosacral strain), based on the C&P examination, citing limitation of flexion.

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 PT examination.  There was no documentation of intervertebral disc syndrome with incapacitating episodes that 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.

AR20180016693, 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.