RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02862
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20080925

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Armament, Electrical, Avionics Systems Repairer, medically separated for “intervertebral disk disease” with a disability rating of 20%.

CI CONTENTION:  His condition has worsened since discharge and other past conditions were not considered.  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 - 20080620	VARD - 20090227	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Intervertebral Disk Disease	5243	20%	L1-S1 Intervertebral Disc Protrusion	5243	10%	20070630	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Intervertebral Disk Disease.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in January 2000 after landing flat footed while playing basketball.  Over the course of the next few years, his pain recurred periodically, but was treated initially with medications and duty limitations and later with epidural steroid injections.  An MRI on 26 February 2008 showed degenerative disk disease at L4-5 and L5-S1.    

The 29 May 2008 MEB NARSUM examination, 4 months prior to separation, noted CI complaints of ongoing low back pain aggravated by activity.  Physical examination revealed a normal gait and neurological findings.  There was tenderness and spasm, but no atrophy or guarding.  Thoracolumbar spine range of motion (ROM) showed flexion to 50 degrees (normal 90) and a combined ROM of 150 degrees (normal 240); painful motion was present.  

At the 23 February 2009 VA Compensation and Pension (C&P) evaluation, 5 months after separation, the CI reported persistent pain, but denied incapacitating episodes.  Physical examination showed a normal gait, spinal contour and neurological findings.  Thoracolumbar spine ROM showed flexion to 85 degrees and a combined ROM of 230 degrees; painful motion was elicited.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, coded 5243 (intervertebral disc syndrome (IVDS)), citing limitation of flexion.  The VA rated the back condition 10%, also coded 5243, based on the C&P examination, citing limitation of flexion.  The panel agreed that a 20% rating, but no higher, was justified for flexion greater than 30 degrees but not greater than 60 degrees as reported on the NARSUM examination.    There was no evidence of IVDS resulting in incapacitating episodes and requiring physician-prescribed bed rest to warrant consideration of rating under the alternate VASRD formula for that condition.  After due deliberation, considering all of 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 intervertebral disk disease 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 20170331, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180008226, 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.

Sincerely,					      
Enclosure