RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03875
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060605

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

CI CONTENTION:  The CI noted his higher VA ratings in his contention.  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 - 20050228	VARD - 20060510	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5237	10%	Musculoligamentous Strain, Lumbosacral Spine	5237	10%	20060428	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain (LBP).  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s LBP began in June 2003 without history of trauma or injury.  X-ray studies were normal.  

At the 26 January 2005 MEB NARSUM examination, 5 months prior to separation, the CI reported constant LBP extending down both legs to the knees aggravated by push-ups, sit-ups, jumping, lifting greater than 20 pounds, standing greater than 1 hour, walking more than one mile or wearing combat gear.  Physical examination (PE) revealed tenderness.  Thoracolumbar range of motion (ROM) was painful and decreased with forward flexion of 55 degrees (normal 90) and combined ROM of 180 degrees (normal 240).  Motor activity and sensation were intact distally with 5/5 strength in both lower extremities.    

At the 28 April 2006 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported continued LBP especially when lying down.  He was limited to sitting for 1 hour, standing for 1.5 to 2 hours, walking one block and lifting up to 20 pounds.  He denied specific flare ups, incontinence or periods of incapacitation.  His PE documented spinal ROMs that were exceedingly greater than that of normal parameters.  The excessive measurements were of such degree that erroneous documentation must be highly considered.  Painful motion was present.  Peripheral sensory and motor components were normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5237 (lumbar spine strain), citing pain limited motion and tenderness.  The VA also rated the back condition 10%, coded 5237, based on the C&P examination, citing limitation of motion.  Panel members first agreed that the documented ROMs in the C&P examination were indeed written in error and to avoid any further erroneous assumptions and or conclusions, complete probative value was apportioned to the MEB NARSUM examination. 

The panel 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.   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 recommends a disability rating of 20% for the back condition, coded 5237.  

BOARD FINDINGS:  In the matter of the low back condition, the panel recommends a disability rating of 20%, coded 5237 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Low Back Pain	5237	20%	

AR20180016712, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear  XXXXXXXXXXXXXXXXXX

The Department of Defense Physical Disability Board of Review (DoD PDBR)
reviewed your application and found that your disability rating should be modified to but
not to the degree that would justify changing your separation for disability with
severance pay to a permanent retirement with disability. I have reviewed the Board’s
recommendation and record of proceedings (copy enclosed) and I accept its
recommendation. This will not result in any change to your separation document or the
amount of severance pay. A copy of this decision will be filed with your Physical
Evaluation Board records. I regret that the facts of the case did not provide you with the
outcome you may have desired.
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.
A copy of this decision has also been provided to the Department of Veterans Affairs.