RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03598
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070421

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Motor Transport Operator, medically separated for “chronic back pain, with lower radicular symptoms, without neurologic abnormality” with a disability rating of 10%.  

CI CONTENTION:  The CI was given a higher rating by the VA for his back condition.  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 – 20070309	VARD - 20070824	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain…	5299-5242	10%	L5-S1 Herniated Disc 	5242	10%	20070501	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Chronic Back Pain, with Lower Radicular Symptoms, without Neurologic Abnormality.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began in June 2005 while lifting large amounts of ammunition while deployed to Iraq.  In June 2006 his back gave out, he fell, and he could not stand up while tightening cargo straps to a load of ammunition.  A lumbosacral MRI in August 2006 showed L4/L5 and L5/S1 degenerative changes, and a mild right L4/L5 paracentral disc herniation associated with a L5/S1 disc herniation.  Electrodiagnostic studies done on 6 September 2006 showed normal right lower extremity nerve conduction and chronic mild L5/S1 radiculopathy.  Neurology did not recommend surgery.  

The 7 February 2007 MEB NARSUM examination, 2 months prior to separation, noted complaints of daily back pain which radiated into both legs, and feet numbness.  Physical examination showed thoracolumbar range of motion (ROM) of flexion to 35 degrees (normal 90) and combined ROM was 90 degrees (normal 240); painful motion was present.  

At the 1 May 2007 VA Compensation and Pension (C&P) examination, less than 1 month after separation, the CI reported daily back pain, stiffness, and flare-ups that occurred at bedtime and upon awakening.  Physical examination showed normal gait with no muscle spasm or tenderness.  Muscle strength was normal.  Thoracolumbar ROM was flexion to 90 degrees and combined ROM was 190 degrees after repetition; painful motion was elicited.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, analogously coded 5299-5242 (degenerative arthritis of the spine), citing ROM limited by pain and localized tenderness.  The VA also rated the back condition 10%, also coded 5242, based on the C&P examination.  

Although the MEB NARSUM flexion ROM supports a 20% rating, the panel agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 60 degrees but not greater than 85 degrees), or combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the VA examination most proximate to separation, and supported by the totally of the STR.  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.  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 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.  

AR20180015553, 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.