RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX  	CASE:  PD-2017-03914
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060519

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Cargo Specialist, medically separated for “chronic low back pain” with a disability rating of 10%.  

CI CONTENTION:  The foot condition has worsened.  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 - 20060317	VARD - 20061026	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5237	10%	Chronic Low Back	5299-5237	NSC	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began in March 2006 after heavy lifting.  X-rays of the thoracic spine revealed 7 degrees of right lower thoracic scoliosis and 12 degrees of left lumbar scoliosis.  The examiner noted the thoracic spine had no other significant findings.  At the orthopedic examination on 30 January 2006, the examiner noted abnormal thoracolumbar spine curvature and tenderness, but no spasm or abnormal gait.  Straight leg raise testing was negative and “thoracolumbar spine demonstrated full range of motion [ROM] without exceptions.”  The 7 February 2006 MEB NARSUM examination, 3 months prior to separation, showed tenderness over the mid spine and paravertebral muscles, particularly over the mid thoracic spine region.  There was no evidence of kyphosis, lumbar lordosis or scoliosis.  Lower extremity strength was 5/5 bilaterally. Straight leg raise and Patrick's testing were negative bilaterally.  At the physical therapy clinic appointment the following week, the thoracolumbar ROM measurements, after repetitive motion, showed flexion of 90 degrees (normal) and combined ROM of 220 degrees (normal 240).  Painful motion was not addressed. There was no VA examination proximate to separation in evidence.   

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, analogously coded 5299-5237 (lumbosacral strain), citing mid-thoracic spine tenderness.  The VA did not rate the back condition, analogously coded 5299-5237, but rather found it not service-connected based on the STR.  

Panel members agreed that a 10% rating, but no higher, was justified for combined ROM (greater than 120 degrees, but not greater than 235 degrees), as reported on the physical therapy ROM examination.  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 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-2017-03914

AR20190010906, XXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXX

	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-2017-03914