RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX 	CASE:  PD-2017-04174
BRANCH OF SERVICE:  army	SEPARATION DATE:  20090511

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty O3, Infantry Officer, medically separated for “intervertebral disc syndrome [IVDS], lumbar region,” with a disability rating of 20%. 

CI CONTENTION:  In addition to the back condition, the CI also requested review of bilateral lower extremity radiculopathies.  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 - 20090127	VARD - 20090521	
Condition	Code	Rating	Condition	Code	Rating	Exam	
IVDS, Lumbar Region	5243	20%	Chronic Low Back Pain	5243	10%	20090414	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:  

IVDS, Lumbar Region.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent L5-S1 hemilaminectomy and microdiscectomy in August 2006.  In April 2008 he developed left-sided pain with radiation down the left leg.  An MRI at that time showed mild bulging at L3-4 and L4-5 touching the corresponding nerve roots.  However, additional surgery was not recommended.

During the 22 May 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 12 months prior to separation, the CI reported chronic lumbar pain.  Physical examination showed low back pain and tenderness with mild weakness of the lower extremities.  

The 31 December 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of constant low back pain aggravated by prolonged standing and walking, sitting, lifting, bending and climbing.  The goniometric range of motion (ROM) study, after repetition, showed flexion of 60 degrees (normal 90) and combined ROM of 160 degrees (normal 240) with pain in all planes of motion.  

At the 14 April 2009 VA Compensation and Pension (C&P) examination, one month before separation, the CI reported low back pain and stiffness with sciatica in both hips.  He also reported decreased mobility, pain, and problems with lifting and carrying, but he denied incapacitating episodes.  Physical examination showed a normal gait and spinal contour with no evidence of spasm, guarding or tenderness.  The thoracolumbar ROM evaluation, after repetition, showed 65 degrees of flexion and 200 degrees of combined ROM with pain.  Motor strength, sensation, and reflexes of the lower extremities were normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, coded 5243 (IVDS), citing forward flexion of 60 degrees.  The VA rated the back condition 10%, also coded 5243, based on the C&P examination, citing “forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined ROM of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees.”  Panel members agreed that at the time of separation no higher than the PEB’s 20% rating was justified.  The NARSUM examination reported limitation of flexion (greater than 30 degrees but not greater than 60 degrees).  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 §471a 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.    

The following documentary evidence was considered:

PD-2017-04174

AR20190012061, XXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX

	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-2017-04174