RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03226
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20071008

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Unit Supply Specialist, medically separated for “chronic low back pain” 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 - 20070510	VARD - 20071024	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5237	10%	Degenerative Disc Disease, Lumbar Spine	5243	10%	20070702	
Left Shoulder Pain	Not Unfitting	Tendonitis, Left Shoulder	5024-5201	0%		
Bilateral Knee Pain		Right Knee Condition	5260	NSC		
		Left Knee Condition	5260	NSC		
Dyspepsia		Gastroesophageal Reflux Disease with Associated Dyspepsia	7346	0%		
Skin Rash		Mastocytosis	7899-7825	10%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Chronic Low Back Pain (LBP). According to the service treatment record and MEB narrative summary (NARSUM), the CI’s low back condition began in 2003 with no particular injury.  In 2006, X-rays indicated lumbosacral spine degenerative disc disease and multiple disc protrusions.  At the 19 March 2007 MEB NARSUM examination, 7 months prior to separation, the CI reported chronic LBP, and the examiner noted spinal tenderness with “full” range of motion (ROM); painful motion, gait, contour and muscle spasms were not addressed.

At the 2 July 2007 VA Compensation and Pension (C&P) examination, 3 months before separation, the CI reported  constant sharp LBP extending into the right leg and aggravated by physical activity, stress, and any movement; she denied periods of incapacitation.  Physical examination showed a normal gait and posture, spinal tenderness, and no muscle spasm.  Flexion was 90 degrees (normal) and combined ROM was 240 (normal); painful motion was present.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the low back condition 10%, analogously coded 5237 (lumbosacral strain), citing spinal tenderness.  The VA also rated the low back condition 10%, coded 5243 (intervertebral disc syndrome (IVDS)), based on the C&P examination, citing lumbar tenderness and pain.  Although there was insufficient limitation of motion to support a minimum rating, members agreed that a 10% rating was appropriate and justified for the persistent presence of spinal tenderness.  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, and considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the LBP condition.

Contended PEB Conditions:  Left Shoulder Pain, Bilateral Knee Pain, Dyspepsia, and Skin Rash.  The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting.  None of the conditions were profiled, implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at or near separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB’s fitness determination for any of the contended conditions, so no additional disability ratings are recommended.

BOARD FINDINGS:  In the matter of the chronic low back pain condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended left shoulder, bilateral knee, dyspepsia and skin rash conditions, the panel recommends no change from the PEB determinations as not unfitting.  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 20170331, w/atchs  
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180009122, 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.

Sincerely,					      
Enclosure