RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02158
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20060502

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Special Electronics Device Repairer, medically separated for “chronic back pain” with a disability rating of 10%.

CI CONTENTION:  Review all conditions.  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 - 20060306	VARD - 20060914	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain	5299 5242	10%	Degenerative Disc Disease…	5237	20%	20060628	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Chronic Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent an L5-S1 laminectomy with discectomy in December 2000 which initially improved his symptoms.  He had a return of back pain during a 2004-2005 deployment without injury or trauma that he attributed to sleeping on cots and wearing heavy gear.  There was no additional surgical indication.

During the 17 January 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI reported low back pain aggravated by load bearing, lifting and standing, walking on uneven terrain, or sitting for prolonged periods.  Physical examination revealed a normal gait and spinal tenderness.  Range of motion (ROM) was decreased but not specified; painful motion was elicited.  During the MEB physical therapy evaluation the next day, repetitive thoracolumbar ROM was flexion to 60 degrees (normal 90) and combined ROM was 180 degrees (normal 240); painful motion was present.  The 21 February 2006 MEB NARSUM examination, 3 months before separation, noted complaints of moderate and frequent low back pain.  Physical examination showed a well-healed surgical scar over his lumbar spine.  Gait, spinal contour, tenderness, muscle spasm, and ROM were not addressed.

At the 26 September 2006 VA Compensation and Pension (C&P) examination, 7 months after separation, the CI reported low back pain.  Physical examination showed a normal gait and spinal contour without tenderness and muscle spasm.  Repetitive thoracolumbar flexion was 70 degrees and combined ROM was 220 degrees; painful motion was present.  There was no decreased in ROM with repetitive motion.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, analogously coded 5299-5242 (degenerative arthritis of the spine), citing ROM limited by pain and localized tenderness without neurologic abnormality.  The VA rated the back condition 20%, coded 5237 (lumbosacral strain), based on the C&P examination, citing limitation of flexion.  Members 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 MEB physical therapy examination most proximate separation.  There was no documentation of intervertebral disc syndrome with incapacitating episodes, which would provide for a higher rating under that formula.  While the CI may have experienced radiating pain from the back condition, this is subsumed under the general spine rating criteria, which specifically states “with or without symptoms such as pain (whether or not it radiates).”  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the back condition, coded 5299 5242.  

BOARD FINDINGS:  In the matter of the chronic back pain, the panel recommends a disability rating of 20%, coded 5299-5242 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Back Pain	5299-5242	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160402, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180012022, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs. 

Sincerely,					      
Enclosure