From: To:

IN   REPLY   REFER  TO:

1850
CORB:003
20 Feb 20

Director, Secretary of the Navy Council of Review Boards 
PD-2017-02312

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr dtd 27 Feb 19 19

1.	Pursuant to reference ·(a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy.

2.	On 12 February 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE: PD-2017-02312 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20080829

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Gunner’s Mate, medically separated for “laminectomy- discectomy, L5-S1” with a disability rating of 20%.

CI CONTENTION:  No specific contention was 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 - 20080627	VARD - 20081210	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Laminectomy-Discectomy, L5-S1, Right, Status Post Laminectomy-Discectomy	5237	20%	Degenerative Disc Disease, Lumbar Spine	5243	10%	20080721	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 30%	
	
ANALYSIS SUMMARY:

Laminectomy Discectomy, L5-S1. According to the service treatment record and Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent an L5-S1 laminectomy- discectomy in September 2007. A lumbar spine MRI on 24 May 2007, 15 months prior to separation, revealed an L4-5 disc bulge and herniation with mild narrowing of the medial facets; and an L5-S1 herniated disc with displacement of the right S1 nerve root. However, postoperative imaging was not in evidence.

During the 21 May 2008 MEB NARSUM examination, 3 months prior to separation, the CI noted complaints of persistent low back pain and upper thoracic discomfort. Physical examination showed a normal gait. Lumbar spine flexion was 45 degrees (normal 90) and combined range of motion (ROM) was 75 degrees (normal 240).  Painful motion was elicited.

At the 21 July 2008 VA Compensation and Pension (C&P) examination, one month before separation, the CI reported intermittent daily back pain when bending forward, sitting for greater than 2 hours, weight bearing for greater than 1 hour, or lifting anything greater than 30 to 40 pounds. Physical examination showed no spinal tenderness or muscle spasms. Repetitive thoracolumbar flexion was 65 degrees and combined ROM was 210 degrees. Painful motion was present.  There was no ROM loss following repetitive use.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the low back condition 20%, coded 5237 (lumbosacral strain). The VA rated the low back condition 10%, coded 5243 (intervertebral disc syndrome (IVDS)), based on the VA 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 MEB NARSUM and VA ROM examinations. There was no documentation of IVDS 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 low back condition.

BOARD FINDINGS: In the matter of the low 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 20170406, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

	PD-2017-02312