RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXX	CASE: PD-2017-03883
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20070604

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Chemical Operations 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’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 - 20070511	VARD - 20071025	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5237	10%	Herniated Disc, Lumbosacral Spine	5003-5242	20%	20070912	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Chronic Low Back Pain (LBP). According to the service treatment record and MEB narrative summary (NARSUM), the CI’s low back condition insidiously began in early 2006. Radiologic imaging revealed degenerative disc disease of the lumbosacral spine with disc herniation at spinal levels L4-S1. Additionally, electrodiagnostic studies revealed findings of a chronic left L4-5 radiculopathy.  Despite conservative therapy, the CI’s back pain remained.

During the 22 February 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI reported LBP and loss of motion, and the examiner documented forward flexion to 70 degrees (normal 90). The 28 March 2007 MEB NARSUM noted

complaints of chronic LBP and referred to the MEB examination findings. Thoracolumbar range of motion (ROM) measurements performed by physical therapy (PT) on 19 April 2007, 2 months before separation, revealed forward flexion to 65 degrees and a combined ROM of 210 degrees (normal 240), after repetition. The examiner noted some localized spinal tenderness, but no muscle spasm or guarding, and no abnormal gait or spinal contour.

At the 12 September 2007 VA Compensation and Pension (C&P) spinal examination, 3 months after separation, the CI reported left lower back pain with radiation down the left leg into the great toe, and daily painful flare-ups lasting 10-15 minutes and causing “marked” restriction of spinal motion. The PE revealed normal spinal contour and no evidence of localized tenderness or swelling. Thoracolumbar ROM measurements recorded forward flexion to 40 degrees and a combined ROM of 190 degrees, after repetition and with painful motion. At the 9 November 2007 VA C&P peripheral nerve examination, 5 months after separation, both peripheral components of sensation and motor activity were normal.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the low back condition 10%, coded 5237 (lumbosacral strain), citing pain on forward flexion to 70 degrees. The VA rated the back condition 20%, dual coded 5003-5242 (arthritis, degenerative-degenerative arthritis of the spine), based on the spinal C&P examination, citing thoracolumbar forward flexion greater than 30 degrees but not greater than 60 degrees. 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), as reported on the MEB and PT examinations prior 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. 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 low back condition and IAW VASRD §4.71a, 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.

PD-2017-03883

AR20190011852, XXXXXXXXXXXXXXXXXXX

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-2017-03883