RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02714
BRANCH OF SERVICE:  ArmY	SEPARATION DATE:  20070215

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Wheeled Vehicle Mechanic, medically separated for “low back pain” with a disability rating of 10%.  

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 - 20070125	VARD - 20070815	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain 	5293	10%	Bulging Disc with Lumbar Stenosis 	5242	10%	20070412	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Back Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began gradually in 2005 during AIT.  An MRI in June 2006 showed mild disc herniation at L5-S1 with an annular tear and disc bulging at L4-5 with congenital stenosis.  At the 16 January 2007 MEB NARSUM examination, 1 month prior to separation, the CI complained, "My back hurts so much I cannot do my job."  He reported constant 3/10 pain with normal daily activities that would increase to an 8/10 with repetitive bending, lifting heavy objects, standing for long periods of time or wearing field gear.  Physical examination showed tenderness and a negative straight leg raise.  Range of motion (ROM) testing showed painful flexion of 85 degrees (normal 90) and combined ROM of 205 degrees (normal 240), after repetition.  

During the 12 April 2007 VA Compensation and Pension (C&P) examination, 2 months after separation and 11 June 2007 VA C&P spine addendum, 4 months after separation, the CI reported difficulty with bending, standing, laying or sitting.  He had dull aching pain and sharp pain down his left leg.  His pain ranged from 3-10/10 with flare-ups caused by both activity and rest.  He could only stand for 15-30 minutes at a time, but had no limitations with walking; however, after walking 12 miles he would collapse to the ground and rest.  He could continue on in pain until his pain level increased to 8-9.  He avoided working on cars, bending, running and playing football.  Physical examination showed normal posture, gait and spinal curvature.  Tenderness was present, but there was no evidence of spasm, atrophy, guarding or weakness.  Painful ROM showed flexion of 90 degrees and combined ROM of 225 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5293 (intervertebral Disc Syndrome), citing thoracolumbar ROM limited by pain, with localized tenderness.  The VA rated the back condition 10%, coded 5242 (degenerative arthritis of the spine), based on the STR and C&P examination, citing combined ROM of the thoracolumbar spine greater than 120 degrees, but not greater than 235 degrees with painful motion and tenderness.  

Panel members noted the PEB may have rated the back condition under the “old” VASRD spine rules, but agreed that a 10% rating, based on the appropriate spine rules, was justified for combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the MEB NARSUM and VA examinations.  There was no muscle spasm or guarding which resulted 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 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 20170313, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190007085, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

	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.