RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXX	CASE: PD-2017-03219
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20050731

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

CI CONTENTION: He was rated higher by the Department of Veterans Affairs. 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 - 20050421	VARD - 20050801	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5235	10%	Compression Fracture, T12	5235	20%	20050517	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Low Back Pain. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began in September 2002 after a hard parachute landing. X- rays were normal. In November 2004, the CI reported increased pain and was not able to run. X-rays demonstrated an anterior wedge compression deformity at T12. The 24 February 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of progressively increasing back pain. Physical examination showed the spine was in line without step offs or deviations. There was tenderness, but no muscle spasms, and the neurologic examination was unremarkable. The 10 March 2005 physical therapy (PT) range of motion (ROM) study, 4 months

VASRD

prior to separation, showed painful flexion of 80 degrees (normal 90) and combined ROM of 225 degrees (normal 240).

At the 17 May 2005 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported constant mid-to-lower back pain rated 10/10 in severity, brought on by physical activity, which limited lifting, standing, driving and stair climbing. Physical examination showed a normal gait and posture. There was tenderness, but no muscle spasm, ankylosis or evidence of nerve root irritation. Neurologic examination was normal. The ROM study showed flexion of 50 degrees with pain occurring at 40 degrees and combined ROM of 140 degrees with pain at 20 degrees during extension and right lateral flexion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the back condition 10%, coded 5235 (vertebral fracture or dislocation). The VA rated the back condition 20%, coded 5235, based on the C&P examination, citing “painful and limited motion.” The panel majority 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 VA C&P examination, which was more proximate to separation and warrants a higher probative value. The panel noted that while the PEB assigned 10% based on the PT rom measurements, the VA examination was after the PEB adjudication, but prior to and closer to separation thereby reflecting the CI’s condition at the time of separation. There was no documentation of intervertebral disc syndrome with incapacitating episodes 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 back condition, coded 5235.

BOARD FINDINGS: In the matter of the back condition, the panel majority recommends a disability rating of 20%, coded 5235 IAW VASRD §4.71a. The single voter for dissent recommended no change but did not elect to submit a minority opinion. 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	
Chronic Low Back Pain	5235	20%	

The following documentary evidence was considered:

AR20190008510, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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 also been provided to the Department of Veterans Affairs. 

Enclosure