RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03548
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090321

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, IT Specialist, medically separated for “chronic low back pain” with a disability rating of 20%.  

CI CONTENTION:  Review all conditions.  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 - 20081215	VARD - 20091005	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5237	20%	Chronic Low Back Strain with Lumbago and Bilateral Leg Radiation	5237	10%	20090318	
Shin Splints	Not Unfitting	Right Chronic Shin Splints	5299-5262	0%		
		Left Chronic Shin Splints	5299-5262	0%		
Hammertoes	Not Unfitting	Right Foot Hammer Toes	5282	0%		
		Left Foot Hammer Toes	5282	0%		
PTSD	Not Unfitting	PTSD	9411	50%	20090921	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  80%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back pain began in October 2002 after falling during basic training.  Spine X-rays in April 2008 were normal.  During the 2 June 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 9 months prior to separation, she reported tingling sensations in both legs, but primarily on the right, and physical examination findings were normal.  The 8 October 2008 MEB NARSUM examination, 5 months before separation, recorded complaints of chronic low back pain.  The examiner noted no muscle spasm or guarding.  Thoracolumbar range of motion (ROM) measurements showed active flexion to 60 degrees (normal 90) and combined ROM of 210 degrees (normal 240), after repetition, with pain on forward flexion and rotational flexion.  

At the 18 March 2008 VA Compensation and Pension (C&P) examination, 1 week before separation, the CI reported daily back pain.  Physical examination revealed no focal tenderness, abnormal spine contour, muscle spasm or guarding.  Active flexion was to 75 degrees with a combined ROM of 225 degrees.  After repetition, flexion was decreased by approximately 10 degrees due to pain, but there was no weakness, fatigue, incoordination, or instability.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, analogously coded 5299-5237 (lumbosacral strain), citing tenderness, no spasm, normal reflexes and strength, and forward flexion to 60 degrees with a functional impairment of an additional 10 degrees due to pain.  The VA rated the back condition 10%, coded 5237, based on the C&P examination, citing thoracolumbar forward flexion greater than 60 degrees but not greater than 85 degrees.  Panel members agreed that a 20% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 60 degrees), as reported on the NARSUM examination.  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 low back condition.  

Contended PEB Conditions:  Shin Splints, Hammertoes and PTSD.  The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting.  None of the conditions were profiled or implicated in the commander’s statement, and did not fail retention standards.  There was no performance-based evidence from the record that any 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 any of the contended conditions, so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the low back condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended shin splint, hammertoe and PTSD 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.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.  

AR20190008457, 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.