RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03237
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20060615

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Infantryman, medically separated for “chronic low back pain” with a disability rating of 10%.

CI CONTENTION:  The CI made no specific contention.  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 - 20060206	VARD - 20070109	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5237	10%	Lumbosacral Strain with DDD	5237-5243	10%	20060327	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain (LBP).  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s LBP began in December 1991 after falling.  Over the years, the back pain continued to worsen.  Radiographic studies from June 2002 and 2004 showed degenerative disc disease (DDD), spondylolisthesis, and spondylosis.  There was no surgical indication.  

The 17 November 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 7 months prior to separation, showed range of motion (ROM) measurements of flexion to 70 degrees (normal 90).  No other measurements were taken.  There was tenderness, but the examination was silent regarding spasm, gait, or spinal contour.  At the 3 December 2005 MEB NARSUM examination, 6 months prior to separation, the CI complained of 5/10 chronic LBP at rest which increased with movement.  Physical examination showed ROM measurements of flexion to 90 degrees and combined ROM of 230 degrees (normal 240).  Straight leg raise testing was negative.  The examination was silent regarding spasm, gait, or spinal contour.  

During the 3 December 2005 VA Compensation and Pension (C&P) examination, 3 months before separation, the CI reported stiffness upon waking or driving long distances.  LBP was worse with strenuous activities.  Physical examination showed tenderness, but was silent regarding spasm, gait, or spinal contour.  ROM testing showed flexion of 85 degrees and combined ROM of 235 degrees.  There was no weakness or fatigability present.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5237 (lumbar spine strain), citing tenderness to palpation and limited ROM.  The VA also rated the back condition 10%, coded 5237-5243 (lumbar spine strain and intervertebral disc syndrome), based on the C&P examination, citing limitation of forward flexion greater than 60 degrees but not greater than 85 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 NARSUM and VA examinations proximate to separation.  There was no muscle spasm or guarding and combined ROM was greater than 120 degrees, thus the next higher 20% rating was not justified.  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 back condition.  

BOARD FINDINGS:  In the matter of the back 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 20170409, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180006231, 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