[AR Number], XXXXXXXXXX

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

Dear XXXXXXXXXX:

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

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-02173
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051015

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, M1 Armor Crewman, medically separated for “chronic radiating low back pain and spasm” 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 - 20050901	VARD - 20060420	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Radiating Low Back Pain and Spasm	5237	10%	Low Back Pain	5299-5237	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Radiating Low Back Pain and Spasm.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began in August 2004 after his tank was destroyed by an explosion.  Radiographic studies were negative.  The 6 June 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, revealed muscle spasm.  The 5 July 2005 MEB NARSUM examination, 3 months prior to separation, noted complaints of constant 7/10 back pain described as tight spastic lumbar pain exacerbated by walking, bending and lifting.  Physical examination showed loss of normal lordosis of the lumbar spine due to muscle spasms.  The CI had visible muscle spasms in the paraspinal muscles on both sides, left slightly greater than right.  The examiner also noted limitation of motion due to pain, but did not provide measurements.  However, the 4 August 2005 physical therapy goniometric range of motion (ROM) study, 2 months prior to separation, showed flexion of 95 degrees (normal 90) and combined ROM of 240 degrees (normal) after truncating measurements.  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 back condition 10%, coded 5237 (lumbosacral strain), citing spasm.  The VA rated the back condition 0%, analogously coded 5299-5237, based on the STR, citing absence of a current examination.  The panel agreed that a 20% rating, but no higher, was justified for muscle spasm severe enough to result in an abnormal spinal contour, as reported on the NARSUM examination.  There was no forward flexion of the thoracolumbar spine 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine, thus the next higher 40% rating was not justified on this basis.  There was no documentation of intervertebral disc syndrome with incapacitating episodes which 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 recommends a disability rating of 20% for the back condition, coded 5237.  

BOARD FINDINGS:  In the matter of the chronic radiating low back pain and spasm condition, the panel recommends a disability rating of 20%, coded 5237 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 Radiating Low Back Pain and Spasm	5237	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170407, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record