RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX  	CASE:  PD-2017-02786
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080725

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Patriot Operator/Maintainer, medically separated for “degenerative arthritis of the spine” with a disability rating of 20%.  

CI CONTENTION:  Review was requested of an additional condition (partial hearing loss in left ear) which was not identified by the Medical Evaluation Board (MEB) and/or Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20080522	VARD - 20080805	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Degenerative Arthritis of the Spine  	5242	20%	Degenerative Disc Disease at L5-S1 with Neural Foraminal Stenosis and Disc Bulging	5243	10%	20080619	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Degenerative Arthritis of the Spine.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s low back condition began in 2001 after he fell off a patriot launching platform.  MRI of the lumbar spine on 3 April 2008, 4 months prior to separation, revealed loss of normal T2 signal within the lower lumbar spine consistent with disc desiccation, focal disc space height loss and bulging at L5-S1, disc bulge with bilateral mild neural foraminal stenosis at L2-L3, L3-L4, disc bulge with moderate to severe bilateral neural foraminal stenosis at L4, disc bulge with moderate bilateral neural foraminal stenosis at L4-L5, and disc bulge resulting in moderate bilateral neural foraminal stenosis without central canal stenosis at the L5-S1.  

During the 25 April 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), the CI reported lower back pain.  Physical examination revealed painful decreased range of motion (ROM) in the lumbar spine.  The 13 May 2008 MEB NARSUM examination, 2 months prior to separation, noted complaints of back pain with left radicular leg symptoms.  Physical examination showed deep tendon reflexes were equal, bilaterally at 2/4.  Sensation was also equal and intact bilaterally.  Clonus and Babinski tests were negative.  Muscle strength was 5/5.  Thoracolumbar ROM referenced measurements performed by physical therapy on 5 May 2008 which showed flexion of 60 degrees (normal 90) and combined ROM of 170 degrees (normal 240) after repetition.  Painful motion was noted.  The CI walked with a normal gait and normal scoliosis and lordosis was noted.  There was no tenderness, but spasm and guarding were noted.  

At the 19 June 2008 VA Compensation and Pension (C&P) examination, one month before separation, the CI reported low back pain.  Physical examination showed he could not walk briskly secondary to his lumbar spine problem, but could walk adequately without any difficulties.  The examiner opined his physical limitation was minimal.  Gait was non-antalgic (normal).  Lumbar spine ROM showed flexion of 90 degrees and combined ROM of 240 degrees after repetition.  Painful motion was noted.  There was no evidence of lack of endurance, fatigability, weakness, or additional loss of motion with repetition.  There were no problems with spasm of the lumbosacral paraspinal muscles and no evidence of abnormal curvature noted.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the low back condition 20%, coded 5242 (degenerative arthritis of the spine), citing forward flexion was limited by pain to 60 degrees.  The VA rated the low back condition 10%, coded 5243 (intervertebral disc syndrome [IVDS]), based on the C&P examination, citing evidence of disc disease and evidence of functional loss due to pain with thoracolumbar spine ROM..  

The panel agreed that that evidence did not support a rating higher than the 20% adjudicated by the PEB.  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 degenerative arthritis of the spine 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.  

AR20200004390 

DearXXXXXXXXXXXXXXXXXXXXXXXXX:

	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.