RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXX	CASE: PD-2017-03239
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20050403

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Aegis Radar System Technician, medically separated for “right lower extremity (RLE) radiculopathy” with a disability rating of 10%.

CI CONTENTION: “...diabetes was worse than believed. Carpal tunnel both wrist was not listed. My VA % went to 40% ….” Review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) appeared to be requested. 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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20050128	VARD - 20060331	
Condition	Code	Rating	Condition	Code	Rating	Exam	
RLE Radiculopathy	8599-8520	10%	DDD, Lumbar Spine	5243	10%	20060325	
Back Pain with DDD	Cat II					
Diabetes	Cat III	Diabetes Mellitus (DM) Type II	7913	10%	20060325	
Hand Pain	Cat III	Carpal Tunnel Syndrome, Right Wrist Associated with DM	8515	10%	20060325	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

RLE Radiculopathy and Back Pain with Degenerative Disc Disease (DDD). According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back and RLE radicular symptoms were noted in January 2004, related to an auto accident in mid-2003. An MRI in 2004 showed mild DDD at  L4-5,  L5-S1 with bulges levels at multiple levels and mild thecal sac

impingement. The CI had a flare of back pain that was refractory to multiple medications, included a RLE sensory radiculopathy. The 12 November 2004 MEB NARSUM examination, 4 months prior to separation, noted complaints of lower back pain made worse with exertional activity. Attention was directed to the 8 September 2004 MEB and indicated that “the physical examination was within normal limits.” At the 13 January 2005 neurology examination, 3 months prior to separation, the CI related continuing significant back pain now with radiating paresthesias and pain down the RLE. The neurologist noted the CI had recently been found fit for full duty on PEB (4 January 2005). Physical examination was deferred. The physician’s impression was mild DDD at L4-5, L5-S1 now causing probable RLE sensory radiculopathy. Restrictions included no heavy lifting (over a gallon of milk), no exertion that requires heavy lifting or back motions such as push-ups and sit-ups, and no contact sports.

At the 25 March 2006 VA Compensation and Pension (C&P) examination, 11 months after separation, the CI reported constant low back pain that radiated down into the right leg. No numbness or weakness was associated with the leg. There was no bowel or bladder impairment and no incapacitating episodes in the prior 12 months. Physical examination showed a normal gait. He had no back tenderness or spasms. Range of motion (ROM) was forward flexion to 80 degrees (normal 90) and combined ROM of 230 degrees (normal 240). There was no pain due to motion or change in ROM due to repetitive motion. X-rays of the lumbar spine were normal.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the RLE radiculopathy condition 10%, analogously coded 8599-8520 (sciatic, paralysis). The PEB also listed “back pain with degenerative disc disease” as a related Category II condition that contributed to the primary unfitting condition, but was not separately ratable. The VA rated the DDD lumbar spine condition 10%, coded 5243 (intervertebral disc syndrome) based on the C&P examination, citing forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees. There was no evidence of weakness or sensory deficit that would support any rating higher than the 10% (mild) radiculopathy peripheral nerve rating adjudicated by the PEB. 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 RLE radiculopathy condition.

Members agreed that the subsumed Category II back pain with DDD was reasonably justified as separately unfitting; the CI’s primary symptoms were back pain, there was diagnostic imaging evidence of lumbar degenerative disease, and the limited duty (LIMDU) form and non-medical assessment ( (NMA) specified back pain as interfering with duty. The PEB reconsideration worksheet (JDETS) noted painful back ROM to normal limits that “did not meet VASRD criteria.” However, although there was insufficient evidence of limitation of motion for rating under the general spine formula ROM limitation criteria, there was STR evidence of painful motion with functional loss supporting a 10% rating (based on §§4.59, 4.40 and 4.45), coded 5242 (degenerative arthritis of the spine). After due deliberation, and considering all the evidence, the panel recommends a separately unfit determination with a disability rating of 10% for the back pain with DDD.

Contended PEB Conditions: Diabetes and Hand Pain. The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting. Neither of the conditions were noted on the LIMDU or NMA, and they did not fail retention standards. There was no performance-based evidence from the record that either of the conditions 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 either of the contended conditions, so no additional disability ratings are recommended.

BOARD FINDINGS: In the matter of the right lower extremity radiculopathy condition and IAW VASRD §4.124a, the panel recommends no change in the PEB adjudication. In the matter of the Category II back pain with degenerative disc disease, the panel recommends a separately unfit determination with a disability rating of 10%, coded 5242, IAW VASRD §4.71a. In the matter of the contended diabetes and hand 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.

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Right Lower Extremity Radiculopathy	8599-8520	10%	
Back Pain with Degenerative Disc Disease	5242	10%	
	COMBINED	20%	

The following documentary evidence was considered:

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO
6040
CORB:003 14 May 21

From: Director, Secretary of the Navy Council of Review Boards To:	XXXXXXXXXXXXXX

Subj:	Physical Disability Board of Review Determination Ref:	(a) 6040.44(Series)
1.	The Physical Disability Board of Review (PBDR) reviewed your case in accordance with reference
(a) and forwarded their recommendation for action.

2.	On 23 April 2021 the Assistant Secretary of the Navy (Manpower and Reserve Affairs) accepted the PDBR’s recommendation of an increase in disability rating to 20%. This decision was then sent to Navy Personnel Command for appropriate action.

3.	The PDBR determination is final and not subject to appeal or review.