RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01965
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070327

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

CI CONTENTION:  No specific contention 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 - 20070214	VARD - 20071219	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain 	5241	20%	Residuals, Lumbosacral Vertebral Fracture 	5237	10%	20070910	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent L5-S1 fusion surgery in July 2005.  The 12 September 2006 functional capacity evaluation showed impaired ability to stoop, bend, kneel, crouch or reach.  There was normal motor strength in the upper and lower extremities and decreased back range of motion (ROM), but measurements were not provided.  On 14 September 2006, 6 months prior to separation, ROM testing, after repetition, showed flexion of 35 degrees (normal 90).  Combined ROM could not be calculated due to the lack of rotation measurements. 

The 25 October 2006 MEB NARSUM examination, 5 months prior to separation, noted complaints of low back pain and stiffness, limited ROM with twisting motion and an inability to run, jump, climb or bend without pain.  Physical examination showed no tenderness and normal motor strength, sensation and reflexes.  However, there was evidence of painful motion and a stiff gait. 

At the 10 September 2007 VA Compensation and Pension (C&P) evaluation, 6 months after separation, the CI reported decreased mobility, muscle spasm and back pain radiating to the  posterior thigh.  Physical examination showed spasm.  Thoracolumbar ROM was flexion of 80 degrees with pain and combined ROM of 220 degrees (normal 240).

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, analogously coded 5241 (spinal fusion), citing a lumbar ROM of 30 degrees with normal strength in the upper and lower extremities.  The VA rated the back condition 10%, analogously coded 5237 (lumbosacral strain), based on the C&P examination, citing forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined ROM of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees. 

The panel agreed that a 20% rating, but no higher, was justified for limitation of forward flexion greater than 30 degrees, but not greater than 60 degrees as noted on the pre-separation ROM evaluation.  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 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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170327, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

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

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-01965.

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 appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						Sincerely,

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings