RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02974
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20080911

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Multiple Launch Rocket System Crewmember, medically separated for “lumbar degenerative disc disease [DDD]” with a disability rating of 10%.

CI CONTENTION:  He requested review of back and headache 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 - 20080603	VARD - 20090126	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbar DDD	5299-5242	10%	Lumbar Strain With Mild DDD	5243	10%	20080923	
Headaches	Not Unfitting	Tension Headaches	8199-8100	0%	20080923	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Lumbar DDD.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in August 2005 after running and physical training.  Diagnostic imaging indicated L5 degenerative joint disease with some spondylolysis; surgery was not recommended.  During the 31 January 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 7 months prior to separation, the CI reported constant low back pain (LBP) which was not improved by physical therapy (PT), electric massage, or injections.  Physical examination revealed a normal gait, thoracolumbar tenderness, and painful limited motion (no measurements provided).  The 16 April 2008 MEB PT evaluation, 5 months before separation, documented no “apparent gait deviations.”  Spine range of motion (ROM) was flexion to 80 degrees (normal 90) and combined ROM was 210 degrees (normal 240), with painful motion and no loss of ROM due to repetition.  The 24 April 2008 MEB NARSUM examination noted complaints of LBP exacerbated by activity, and physical examination showed a normal gait with lumbar muscle tenderness.

At the 23 September 2008 VA Compensation and Pension (C&P) examination, less than 1 month after separation, the CI reported daily chronic LBP with flares due to activity.  The examiner documented a steady gait, and spinal flexion was to 90 degrees with a combined ROM of 190 degrees; pain was present and there was no loss of ROM with repetition.  On 30 March 2009, 7 months after separation, the CI underwent back surgery (spondylolysis repair with bone graft and L5 bilateral fixation with hardware).

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, analogously coded 5299-5242 (degenerative arthritis of the spine), citing tenderness and limitation of motion.  The VA rated the back condition 10%, coded 5243 (intervertebral disc syndrome (IVDS)), based on the C&P examination, citing spinal tenderness.  Members agreed that a 10% rating, but no higher, was justified for limitation of combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the MEB PT and VA examinations.  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 documentation of IVDS with incapacitating episodes which would provide for a higher rating under that formula.  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 lumbar DDD condition.

Contended PEB Condition:  Headaches.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not profiled, implicated in the commander’s statement, or judged to fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.

BOARD FINDINGS:  In the matter of the lumbar DDD and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended headaches condition, the panel agrees it cannot recommend it for additional disability rating.  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 20170418, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record  

AR20180008812, 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. 

A copy of this decision has been provided to the counsel you listed on your application, XXXXXXXXXXXXXXXXXX.

Sincerely,					      
Enclosure