RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX  	CASE:  PD-2017-03928
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060327

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

CI CONTENTION:  Review of all conditions requested.  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 - 20060221	VARD - 20070430	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain 	5242	10%	Osteoarthritis Lumbar Spine 	5242	10%	20061211	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in 2004 after ruck-marching without specific trauma or injury.  Radiographic studies of the back showed mild thoracic dextroscoliosis and minimal rotoscoliosis to the right.  At the 28 November 2005 MEB physical therapy (PT) clinic appointment, 4 months prior to separation, thoracolumbar range of motion (ROM) measurements, after repetitive motion, showed flexion of 90 degrees (normal) and combined ROM of 210 degrees (normal 240), limited by pain.  The 28 December 2005 MEB NARSUM examination, 3 months prior to separation, noted complaints of mid and lower back pain.  The examiner noted mild scoliosis but no excess lordosis or kyphosis.  Physical examination showed tenderness.  Straight leg raise testing was negative, bilaterally.  Lower extremity strength was normal.  The CI had full ROM on extension and flexion, but decreased ROM on lateral flexion.  The amount of limitation was not specified. 

At the 11 December 2006 VA Compensation and Pension (C&P) examination, 9 months after separation, the CI reported burning, aching and sharp back pain.  The examiner noted the CI’s posture and gait were within normal limits.  Physical examination showed no evidence of radiating pain on movement and no muscle spasm or tenderness.  There was symmetry of spinal motion with normal curvatures of the spine.  Straight leg raise testing was negative.  Thoracolumbar ROM testing showed flexion of 90 degrees and combined ROM of 240 degrees.  X-rays showed good alignment throughout the lumbar spine with disc spaces preserved and vertebral body height maintained.  The sacroiliac joints were unremarkable.  There were no signs of intervertebral disc syndrome with chronic and permanent nerve root involvement.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB and the VA rated the back condition 10%, coded 5242 (degenerative arthritis of the spine).The PEB cited positive tenderness and ROM limited by pain.  The VA based the rating on the C&P examination, citing intermittent daily episodes of painful or limited motion of the lumbar spine.  The panel agreed that a 10% rating, but no higher, was justified for limitation of combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the PT examination proximate to separation.   Although there was evidence of scoliosis, there was no evidence of muscle spasm or guarding, 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.  

AR20190010911, XXXXXXXXXXXXX

Dear XXXXXXXXX:

	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.