RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXX	CASE: PD-2017-03870
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20030711

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

CI CONTENTION:  No specific contention was 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 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 - 20030513	VARD - 20040105	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-
5295	10%	Degenerative Disc Disease and Herniated Nucleus Pulposus at L4-5 and L5-S1	5299-
5293	10%	20031001	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 60%	

ANALYSIS SUMMARY:

Chronic Low Back Pain (LBP). According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in 1996 after a lifting incident. The 3 August 2002 MEB NARSUM examination, 11 months prior to separation, noted complaints of LBP. Physical examination (PE) revealed a normal gait and spinal flexion was 90 degrees, but extension was only 15 degrees, and painful motion was present. The 25 March 2003 MEB NARSUM addendum, 4 months before separation, noted complaints of LBP. The PE showed lumbar flexion of 90 degrees and extension of 25 to 30 degrees. At the 1 October 2003 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported LBP. The PE showed lumbar flexion of 80 degrees and combined range of motion of 230 degrees (normal 240) with painful motion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the back condition 10%, analogously coded 5299-5295 (lumbosacral strain), citing painful  motion.    The  VA  also  rated  the  back  condition  10%,  analogously  coded 5299-5293

(intervertebral disc syndrome (IVDS)), based on the C&P examination, citing limitation of flexion. In accordance with DoDI 6040.44, the panel is required to recommend a rating IAW the VASRD in effect at the time of separation which in this case, was the 2003 VASRD Spine Rules.

The panel agreed that a 10% rating, but no higher, was justified under either code of 5295 for characteristic pain on motion or 5292 for slight limitation of motion as evidenced in the NARSUM and VA examinations. 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.

BOARD FINDINGS: In the matter of the back condition and IAW VASRD 2003 spine rules, the panel recommends no change in the PEB adjudication. There were 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.

2	PD-2017-03870

Dear XXXXXXXXXXXXXX:

	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-2017-03870