RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX		CASE: PD-2017-02921 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20081027

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was active duty E3, Military Police, medically separated for “degenerative arthritis, lumbar spine” with a disability rating of 10%.

CI CONTENTION: “Discharged for back issues but initially went to the doctors for hips. Back issues have now caused worse issues in back/hips.”  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 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 - 20080827	VARD - 20090218	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Degenerative Arthritis, Lumbar Spine	5242	10%	Degenerative Joint Disease, Lumbar Spine	5242	10%	20090203	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Lumbar Spine Degenerative Arthritis. According to the service treatment record and MEB narrative summary (NARSUM), the CI first experienced bilateral hip pain in March 2007 while running during basic training. The pain gradually became constant, and in In March 2008, she also developed low back pain. A lumbar spine MRI in March 2008 showed minimal facet hypertrophy contributing to mild narrowing of the neural foramina without direct nerve root compromise. There was no evidence of focal disc protrusion or significant central canal stenosis.

At the 24 July 2003 MEB physical therapy (PT) range of motion (ROM) evaluation, 3 months prior to separation, the CI described her pain as a permanent ache, rated at 7/10, and increased to 10/10 when aggravated. Goniometric thoracolumbar ROM measurements showed flexion of 90 degrees (normal) and combined ROM of 235 degrees (normal 240) after repetition. During the 18 August 2008 MEB NARSUM examination, the CI complained of back pain that interfered with sleep, but was otherwise tolerable unless exacerbated by extensive activity. Physical examination showed a normal gait, with tenderness and a slight spasm, but no guarding.      The

examiner noted that ROM was consistent with earlier PT measurements, except for forward flexion, which was reduced to about 70 degrees. Fatigue, weakness, lack of endurance, and incoordination did not significantly limit functional ability.

At the 3 February 2009 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the CI reported mild aching lower back pain aggravated by activity. Physical examination showed a normal gait and spinal contour, with tenderness and painful motion. There were no ROM measurements.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the lumbar spine condition 10%, coded 5242 (degenerative arthritis of the spine), citing forward flexion of 93 degrees, and a combined ROM of 245 degrees. The VA also rated the lumbar spine condition 10%, coded 5242, based on the C&P examination, citing muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or spinal contour. 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) and/or combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the PT and NARSUM examinations proximate to separation. There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis. 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. 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 lumbar spine condition.

BOARD FINDINGS: In the matter of the lumbar 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.

The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20170308, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

PD-2017-02921 

AR20190015557, XXXXXXXXXXXXXXXXXXXXXXX

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.

PD-2017-02921