RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02461
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070513

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Automated Logistics Specialist, medically separated for “intervertebral disk syndrome causing chronic low back pain” 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 - 20070405	VARD - 20080118	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Intervertebral Disk Syndrome with Chronic Low Back Pain	5243	20%	Degenerative Disk Disease, Lumbar Spine	5242	10%	20070720	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  10% 	

ANALYSIS SUMMARY:  

Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent artificial L3-4 disc replacement in October 2006.  The 15 February 2007 MEB NARSUM examination, 3 months prior to separation, noted complaints of back pain and activity-associated intermittent radicular pain.  Physical examination showed a negative straight leg raise (SLR) test and normal reflexes without motor or sensory deficits.  Thoracolumbar range of motion (ROM) measurements showed flexion of 70 degrees (normal 90) and combined ROM of 190 degrees (normal 240) with painful motion after repetition.  

At the 20 July 2007 VA Compensation and Pension (C&P) examination, 2 months after separation, physical examination showed mild tenderness over the mid-portion of the lumbar spine.  Thoracolumbar ROM measurements showed flexion of 70 degrees and combined ROM of 190 degrees with painful and pain-limited motion.  There was no weakness, fatigability, incoordination or lack of endurance with repetitive motion.  Sensation was decreased to light touch over the right lateral calf and ankle but was otherwise intact.  Strength and reflexes were normal and SLR testing was negative bilaterally.  

During the 29 October 2007 orthopedic evaluation, 5 months after separation, the CI reported increased back pain and muscle spasms.  Physical examination showed muscle spasms without guarding or an abnormal gait.  Lumbar flexion was 75 degrees.  Lumbar spine X-rays showed the disc replacement in good position.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, analogously coded 5243 (intervertebral disc syndrome), citing spasm or guarding causing alteration in gait.  The VA rated the back condition 10%, analogously coded 5242 (degenerative arthritis of the spine), based on the C&P examination, citing forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined ROM of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees.  

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) as reported at all examinations proximate to separation.  There was no evidence of intervertebral disc syndrome which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under that alternate VASRD formula.  The panel may not recommend a lower combined rating than the PEB IAW DoDI 6040.44.  Therefore, no change to the PEB’s adjudication is recommended.  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 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 20170417, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180015177, XXXXXXXXXXXXXXXXXX (Deceased)

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your deceased spouse’s separation disability rating and his 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