RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-03269
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060203

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Pavements and Construction Equipment Journeyman, medically separated for “low back pain” with a disability rating of 10%.  

CI CONTENTION:  The condition continues to worsen and negatively impacts daily activities.  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 - 20051206	VARD - 20060615	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Low Back Pain	5241	10%	Herniated Disc, L4-5 and L5-S1	5243	10%	20060605	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent back surgery with fusion in August 2004 for herniated discs at L4-5 and L5-S1.  Post-surgical X-rays showed no change in alignment and a solid looking fusion.  The only pre-separation range of motion (ROM) evaluation in evidence was done by physical therapy and showed limited motion, but excluded measurements in degrees and did not mention painful motion.  The 28 November 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of continued low back pain.  A physical examination was not completed.  

At the 5 June 2006 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported that he was not able to work due to his back.  He denied any incapacitating episodes in the past year.  Physical examination showed normal gait and posture, but there was tenderness.  The ROM evaluation showed flexion of 85 degrees (normal 90) and combined ROM of 150 (normal 240), limited by pain.  There was no addition loss of ROM with repetition and no report of spasm.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5241 (spinal fusion).  The VA also rated the back condition 10%, coded 5243 (intervertebral disc syndrome), based on the C&P examination, citing slight limitation of motion.  The panel agreed that a 10% rating, but no higher, was justified for limitation of flexion as reported on the VA examination proximate to separation.  There was neither incapacitating episodes nor muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour to support the next higher 20% rating.  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:

SAF/MRB

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-03269.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						

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