RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03523
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090830 

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Wheeled Vehicle Mechanic, medically separated for “lumbar intervertebral disc syndrome” with a disability rating of 10%.   

CI CONTENTION:  The CI’s condition continues to worsen and affect his life.  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 - 20090604	VARD - 20090924	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbar Intervertebral Disc Syndrome	5243 	10%	Spondylosis with Disc Bulge at L4-L5, Thoracolumbar Spine	5237	10%	20090709	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Lumbar Intervertebral Disc Syndrome.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in 2007 without any specific injury or trauma.  X-rays and a thoracic spine MRI were normal, but a lumbar spine MRI revealed a disc bulge at L4-5 mildly compressing the spinal canal.  A civilian neurosurgeon recommended against surgical intervention.  

The 12 May 2009 MEB NARSUM examination, 4 months prior to separation, noted complaints of constant low back pain that occurred daily with an average subjective pain level of 5/10.  He described flare-ups of his low back pain at which time his subjective pain level was 9/10.  The duration of the flare-up was usually 30 minutes to 1 hour with a typical frequency of one to two times per week.  The precipitating factors described were repeated lifting activities or any type of high impact activity such as running or jumping.  Physical examination showed a normal gait and no tenderness, spasm or abnormal spinal contour.  Thoracolumbar range of motion (ROM) measurements showed flexion of 90 degrees (normal) and combined ROM of 240 degrees (normal).  

At the 9 July 2009 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported severe constant localized back pain.  The pain could be elicited by physical activity.  Physical examination showed a normal gait.  There was lumbosacral spine tenderness and muscle spasm which did not produce an abnormal gait.  Thoracolumbar ROM measurements showed flexion of 90 degrees and combined ROM of 210 degrees after repetition.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5243 (intervertebral disc syndrome), citing functional loss and painful motion IAW VASRD §4.10, §4.40, §4.45 and §4.59.  The VA also rated the back condition 10%, coded 5237 (lumbar spine strain), based on the C&P examination, citing combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees.  The panel agreed that a 10% rating, but no higher, was justified for limitation of combined ROM greater than 120 degrees but not greater than 235 degrees, as reported on the VA examination.  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 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 20170505, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180008991, 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