RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02219
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051202

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a National Guard E5, Signal Support Systems Specialist, medically separated for “chronic back pain” with a disability rating of 10%.  

CI CONTENTION:  A higher disability rating is justified based on various quality of life factors.  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 - 20051028	VARD - 20060410	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain	5241	10%	Low Back Pain…	5241	10%	20060210	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent surgery in May 2005 for lumbar fusion at multiple vertebral levels. Radiologic studies performed after the surgery showed normal spinal alignment and intact surgical hardware.  Physical therapy-measured range of motion (ROM) for the MEB on 14 September 2005, 3 months prior to separation, and after three repetitions, was flexion 55 degrees (normal 90) with a combined ROM of 135 degrees (normal 240).  The therapist noted limitation was due to pain.  

During the 16 September 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), the CI reported back pain brought on by jumping, bending, running, or prolonged sitting or standing (greater than 30 minutes).  Physical examination showed a normal gait with decreased ROM and painful motion.  There was no tenderness of the back.  One week later, the MEB NARSUM examination noted complaints of pain and reduced back strength, flexibility, and mobility.  Physical examination showed back spasms from the mid-to-lower back.  Testing for nerve root impingement was negative, and neurologic examination was normal with the exception of some slight decrease in sensation in the L5 radicular distribution bilaterally.  

At the 10 February 2006 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported ongoing morning back pain and stiffness relieved by walking.  Physical examination showed a normal gait and posture with moderate lumbar spine flattening, but no muscle spasm.  Painful motion was noted, and ROM was recorded as flexion to 70 degrees with a combined ROM of 175 degrees.  Neurologic examination was normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB and the VA each rated the back condition at 10%, coded 5241 (spinal fusion), with the VA rating based on the C&P examination.  The panel agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 60 degrees but not greater than 85 degrees) and/or combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the VA examination.  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 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 concluded there was insufficient cause to recommend a change in the PEB adjudication for the back condition.  

BOARD FINDINGS:  In the matter of the chronic back pain 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 20170306, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190004135, XXXXXXXXXXXXXXXXXXXX

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Dear XXXXXXXXXXXXXXXXXXXX:

	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