RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXX	CASE: PD-2017-03793
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20060524

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Motor Transport Operator, medically separated for “chronic radiating low back pain” with a disability rating of 10%.

CI CONTENTION: Requested review of back and knee 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 - 20060130	VARD - 20060619	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Radiating Low Back Pain	5243	10%	Degenerative Lumbar Disc Disease	5242	10%	20060418	
Chronic Knee Pain with Bilateral Retropatellar Syndrome (RPS)	Not Unfitting	Left Knee RPS	5260-
5024	10%	20060418	
		Right Knee RPS		10%		
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Chronic Radiating Low Back Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in 2000 without trauma or injury, and he then developed left radicular pain in July 2003, shortly after redeployment. An MRI showed a herniated disc at L4-5 and he underwent a lumbar discectomy in March 2004. The left radicular pain recurred in January 2005 and a new MRI showed recurrent herniation at L4-5.

During the 25 October 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 7 months prior to separation, the CI reported lower back pain and stiffness with numbness and tingling down the left leg to the thigh. Physical examination showed tenderness and decreased range of motion (ROM) of the thoracolumbar spine, but no measurements were included. Straight leg raise testing was negative for radicular signs, and motor strength, reflexes and sensation were normal. Heel and toe walk was intact. The 26 October 2005 physical therapy examiner stated that the CI had “full ROM of thoracolumbar spine.” The 3 November 2005 MEB NARSUM examination noted complaints of low back pain and intermittent left sciatica. The physical examination repeated findings from the MEB examination.

At the 18 April 2006 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported intermittent low back pain, rated at 10/10, that traveled to the right thigh and calf, and occurred 5 times a day with physical activity. However, he denied any incapacitation. Physical examination showed normal gait and posture without back spasm or tenderness. Straight leg raise testing was negative and there were no signs of intervertebral disc syndrome (IVDS) with chronic and permanent nerve root involvement. The ROM study, after repetitive motion, showed pain-limited flexion of 80 degrees (normal 90) and combined ROM of 230 degrees (normal 240), with pain on right lateral flexion and right rotation.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the back condition 10%, coded 5243 (IVDS), citing tenderness. The VA also rated the back condition 10%, but coded 5242 (degenerative arthritis of the spine), based on the C&P examination, citing forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees. Panel members agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 60 degrees but not greater than 85 degrees) as reported on the VA examination proximate to separation. 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 evidence of IVDS which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under the alternate VASRD formula for that condition. 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.

Contended PEB Condition: Bilateral Knee Pain. The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. The contended condition was not profiled or implicated in the commander’s statement, and did not fail retention standards. 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 back condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication. In the matter of the contended bilateral knee condition, the panel recommends no change from the PEB determination 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.

The following documentary evidence was considered:

PD-2017-03793

AR20190010892, XXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXX

	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.

PD-2017-03793