RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03532
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070321

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Material Management Journeyman, medically separated for “radiculopathy with weakness of left hip flexors” with a disability rating of 10%. 

CI CONTENTION:  “Believe that due to my conditions I should have been considered for medical retirement.”  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 - 20070228	VARD - 20080327	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Radiculopathy with Weakness of the Left Hip Flexors	8526	10%	 Radiculopathy, Left Lower Extremity	8520	20%	20080117	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40% 	

ANALYSIS SUMMARY:  

Radiculopathy with Weakness of the Left Hip Flexors.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent L4-5 discectomy and fusion in February 2006.  Her back pain resolved, but she continued to suffer from left leg weakness and numbness.  The 6 December 2006 primary care examination, 3 months prior to separation, noted left lower leg numbness.  Physical examination showed a slight decrease in sensation to light touch of the left inner thigh and anterior shin.  Motor examination and gait were normal.  During the 19 January 2007 MEB NARSUM examination, 2 months prior to separation, the CI complained of left calf and thigh numbness radiating to the toes.  She reported that her left leg gave out with fast walking or running.  Physical examination showed negative straight leg raise testing.  Left hip strength was slightly below normal at 4/5 with extension and flexion.  Left knee extension and flexion, great toe extension, eversion/inversion showed normal 5/5 strength.  There was decreased light touch sensation on the left front of the leg and top of the foot, but reflexes were normal.  

The 17 January 2008 VA Compensation and Pension (C&P) evaluation, 10 months after separation, recorded no specific complaints.  Physical examination showed no muscle atrophy and normal motor strength, but both the left foot extensor muscles and flexor muscles were a little weaker than on the right side. Sensory examination showed distinct numbness about the lower half of the front left thigh, the side and back left thigh, the front side and front lower left leg and the entire left foot to include the toes.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left radiculopathy 10%, coded 8526 (femoral nerve incomplete paralysis).  The VA rated the left radiculopathy 20%, coded 8520 (sciatic nerve incomplete paralysis), based on the C&P examination, citing slightly weaker left foot extensor and flexor muscles than on the right.  The panel noted that the C&P examination was more detailed and therefore of more probative value.  The panel agreed that a 20% rating was justified for moderate incomplete paralysis of the sciatic nerve as evidenced by both motor weakness of the left foot and sensory loss along the left lower leg described on the C&P examination.  The CI had a normal gait and symptoms of weakness occurred only with fast walking or running and therefore the condition did not reach the moderately severe level for the next higher 40% rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the left radiculopathy, coded 8520.  

Contended PEB Condition:  Status Post L4-5 Discectomy and Fusion with Relief of Back Pain.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  Although the contended condition was profiled, it was judged to meet retention standards.  The NARSUM examination demonstrated full range of motion through flexion, extension, rotation and lateral flexion without any pain.  There was no performance-based evidence from the record that the condition 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 the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the left lower extremity radiculopathy, the panel recommends a disability rating of 20%, coded 8520 IAW VASRD §4.124a.  In the matter of the contended back condition, the panel agrees it cannot recommend it for additional disability rating.  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	
Radiculopathy with Weakness of Left Hip Flexors	8520	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170509, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-03532.

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 not appropriate under the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended modification of your assigned disability rating without re-characterization of your separation with severance pay. 

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding, accept their recommendation and direct that your records be corrected as set forth in the attached copy of a Memorandum for the Chief of Staff, United States Air Force.  This will not result in any change to your separation documents or the amount of severance pay you are entitled to.  Disability severance pay is computed the same regardless of a rating of 0, 10 or 20 percent.

						Sincerely,

		

								

Attachments:
1.  Directive 
2.  Reco