RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-03574
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060308

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Integrated Avionic Systems, medically separated for “chronic back pain” with a disability rating of 10%. 

CI CONTENTION:  No specific contention made.  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 - 20051130	VARD – 20060309	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain	5237	10%	Chronic Back Pain	5237	10%	20060417	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in 2004 without precipitating event or trauma.  X-rays and MRI were both normal.   The 23 September 2005 MEB NARSUM examination, 6 months prior to separation, noted complaints of dull-achy back pain that was worse with running.  He denied bowel or bladder dysfunction.  Physical examination showed normal spinal curvature, gait and neurological evaluation.  The examiner noted the range of motion (ROM) was normal and the CI was “able to touch his hands to the floor.”  

At the 8 November 2005 family medicine examination, 4 months prior to separation, the CI reported low back spasms and numbness in the back of his legs.  Physical examination showed a normal gait without spinal tenderness, but there was muscle spasm.  The neurological evaluation was within normal limits.  Forward flexion was recorded as “hands to floor.”  

During the 17 April 2006 VA Compensation and Pension (C&P) examination, 1 month after separation, the CI reported leg numbness, daily back pain, weakness and stiffness.  Flare-ups lasting 4-5 hours occurred with standing or increased activities.  Physical examination showed a normal gait and spine without muscle weakness, atrophy or spasm.  There was tenderness over the lower lumbar spine along the midline.  The ROM evaluation showed forward flexion of 90 degrees (normal) and combined ROM of 240 degrees (normal), with pain.  Motor strength, sensation and reflexes were normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5237 (lumbosacral strain).  The VA also rated the back condition 10%, coded 5237 (lumbosacral strain), based on the C&P examination.  
 
There was no limitation of motion to support a 10% rating under the General Rating Formula for Diseases and Injuries of the Spine; however, the VA examination noted both the presence of painful motion and localized tenderness, warranting a 10% rating.  There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis.  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 §4.71, 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 20170328, 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-2017-03574.

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.

						Sincerely,

		

Attachment:
Record of Proceedings