RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXX	CASE: PD-2017-02448
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060726

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Indirect Fire Infantry, medically separated for “chronic back pain” with a disability rating of 10%.

CI CONTENTION: “Rating is for back injury and it effects my legs and knees.” 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 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 - 20060522	VARD - 20070920	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain	5243	10%	Low Back Pain, Post Lumbar Laminectomy (L4-5) for Herniated Nucleus Pulposus, Absent Neurological Abnormality	5237	0%	STR	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 0%	

ANALYSIS SUMMARY:

Chronic Back Pain. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back pain condition began in October 2005 after falling. He underwent an L4-5 lumbar laminotomy for a herniated nucleus pulposus in January 2006. The 14 March 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of limitation of motion, stiffness and intermittent pain with a severity of 5/10. Physical examination showed a normal gait, mild tenderness in the lower spine, and a well-healed midline scar. There was no sacroiliac pain. Thoracolumbar range of motion (ROM) measurements incorporated the MEB examination findings, which showed flexion of 60 degrees (normal 90) and combined ROM 180 (normal 240) with painful motion noted. 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  pain  condition  10%,  coded  5243  (intervertebral  disc  syndrome),  citing

thoracolumbar ROM limited by pain, with localized tenderness. 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 and NARSUM examinations. 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 pain condition, coded 5243.

BOARD FINDINGS: In the matter of the chronic back condition, the panel recommends a disability rating of 20%, coded 5243 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	5243	20%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170221, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20190015508, XXXXXXXXXXXXXX 

Dear XXXXXXXXXXX

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