DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS
720 KENNON STREET SE STE 309 WASHINGTON  NAVY  YARD,   DC  20374

lN  l<Ef'LY   EIT!l TO:
1850
CORB:003
27 Feb 20

From:	Director, Secretary of the Navy Council of Review Boards To:	PD-2017-02887

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr of 8 Apr 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy for appropriate   action.

2.	On 21 February 2020, the Assistant General Counsel of the Navy (Manpower & Reserve Affairs) took action in your case by accepting the recommendation of the PDBR.	Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEB) from 10% to 20% without re-characterization of your discharge.

3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement  to  additional  compensation.

4.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, has been forwarded to the Navy Personnel Command for appropriate changes to your personnel records and notification to you upon  completion.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02887 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20080813

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Boatswains Mate, medically separated for “back pain/lumbago” with a disability rating of 10%.

CI CONTENTION:  “Review all conditions.”  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 - 20080501	VARD - 20080929	
Condition	Code	Rating	Condition	Code	Rating	Exam	
History of Back Pain/Lumbago	5237	10%	DDD with Spondylosis and Chronic Lumbosacral Strain/Sprain	5243	20%	20080605	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 60%	

ANALYSIS SUMMARY:

Back Pain/Lumbago. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s low back condition began in 2004 when he fell from his bed. X-rays of the lumbar spine on 1 November 2007 revealed a stable appearing lumbar spine with minimal lumbosacral  junction  disc   space   narrowing   (degenerative   disc   disease   [DDD]).   At   the 21 December 2007 pain management clinic, 8 months prior to separation, the CI reported 9/10 low back pain (LBP). On examination the CI’s gait and stance were normal. The lumbosacral spine exhibited spasms and tenderness at the left paraspinal muscles and a straight leg raise (SLR) test was negative. The lumbosacral spine exhibited a normal appearance and motion was normal though pain was elicited with extension.

The 29 February 2008 MEB NARSUM examination, 5 months prior to separation, noted complaints of 6/10 LBP (75%) and leg pain (25%), with symptoms worse during and after exercise, and with prolonged standing. Symptoms improved with sitting, lying down, or shifting positions. Physical examination showed the CI walked with a normal gait. He had 4-5/5 motor strength in all muscle groups tested with normal sensation to light touch in the L1-S1 distribution and symmetric deep tendon reflexes. Thoracolumbar range of motion (ROM) showed flexion of greater than 50 degrees (normal 90) and combined ROM of 200 degrees (normal 240).

At the 5 June 2008 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported episodic LBP, with spasms that occurred once a month lasting about 4 days. He said the pain kept him stiff, and limited or gave him difficulty with running. He stated in the last year he lost 45 days due to bedrest because of severe back spasm. Physical examination showed posture and gait as “reasonably normal,” with 2 cm shorter right leg than left due to a shorter right tibia from childhood fracture. There was paraspinous muscle tightness and marked tenderness over the left iliopsoas with deep palpations through the left iliac area. There was tenderness on the insertion of the iliopsoas muscle on the left greater trochanter as well. He had a normal SLR testing to 80 degrees and deep tendon reflexes were 2+ (normal). Lumbosacral spine ROM, after repetition, showed flexion of 50 degrees and combined ROM of 175 degrees with painful motion noted.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the low back condition 10%, coded 5237 (lumbosacral strain). The VA rated the low back condition 20%, coded 5243 (intervertebral disc syndrome [IVDS]), based on the C&P examination, citing limited motion after repetitive movements. 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 NARSUM and C&P examinations proximate to separation. Although the C&P history indicated lost workdays due to bedrest, there was no documentation of IVDS with incapacitating episodes with physician-prescribed bed rest, 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 low back condition, coded 5237.

BOARD FINDINGS: In the matter of the low back condition, the panel recommends a disability rating of 20%, coded 5237 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	
History of Back Pain/Lumbago	5237	20%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170403, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

2	PD-2017-02887