RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02955
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081203

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Attack Helicopter Repairer, medically separated for “degenerative arthritis, lumbar spine” with a disability rating of 10%.  

CI CONTENTION:  In addition to the back condition, the CI requested another condition not identified by the Medical Evaluation Board (MEB) and 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 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 - 20080814	VARD - 20090520	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Degenerative Arthritis, Lumbar Spine	5242	10%	Degenerative Joint Disease, Lumbar Spine	5242	0%	20090102	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Degenerative Arthritis, Lumbar Spine.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in April 2007 following a motor vehicle accident.  While deployed, the CI developed increased back pain and stiffness after long hours of wearing his IBA.  The pain increased to the point that the CI required medical evacuation.  Initial MRI was negative, but an MRI in June 2008 showed L4-5 degenerative facet changes.

The 10 June 2008 physical therapy (PT) range of motion (ROM) examination, 6 months prior to separation, noted forward flexion of 80 degrees (normal 90) and combined ROM of 225 degrees (normal 240).  Painful motion was noted.  The 17 July 2008 MEB NARSUM examination, 5 months prior to separation, noted complaints of constant 3-5/10 back pain that increased to 8-9/10, but flares were not related to activity.  Physical examination showed tenderness, but no muscle spasm, and gait and strength were normal.  

At the 2 January 2009 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported constant lower back pain with intermittent radiating pain into the buttocks due to prolonged standing, walking, lifting or climbing stairs.  Physical examination showed no tenderness, muscle spasm or deformity, and a normal gait.  The ROM study showed flexion of 90 degrees, without pain, and combined ROM of 240 degrees.  Repetitive motion did not elicit pain or decrease motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5242 (degenerative arthritis of the spine) citing forward flexion of 80 degrees and combined ROM of 225 degrees.  The VA rated the back condition 0%, coded 5242 based on the C&P examination, citing forward flexion of the thoracolumbar spine greater than 85 degrees, or combined ROM of the thoracolumbar spine greater than 235 degrees.  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) as reported on the physical therapy examination.  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 §4.71, 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 20170330, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190008788, XXXXXXXXXXXXXXXXXX 

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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.