RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE: pd-2017-04427
BRANCH OF SERVICE:  army	SEPARATION DATE:  20060419

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Patriot System Repairer, medically separated for “chronic low back pain” with a disability rating of 10%.

CI CONTENTION:  His condition was misdiagnosed, and there were other injuries related to his discharge that should have been evaluated.  The CI’s 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 - 20060207	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5237	10%	No VA Exam Proximate to Separation in Evidence	
Cervicalgia 	Not Unfitting		
Myofasciitis, Right Medial Scapula			
Old Subluxation of Right Tenth Costovertebral Junction			
Mild Congenital Abnormalities			
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:

Low Back Pain (LBP).  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began insidiously in August 2004 without specific incident or injury.  X-rays revealed spina bifida occulta.  Surgical intervention was not indicated.  The 5 October 2005 MEB NARSUM examination, 7 months prior to separation, noted complaints of constant LBP aggravated by running, wearing military gear, heavy lifting, ruck marches, push-ups, sit-ups or jumping.  His physical examination (PE) revealed a normal gait and posture.  Spinal tenderness and muscle spasms were present.  Spinal range of motion (ROM) was documented as flexion to within two inches from the foot (approximately 70 to 80 degrees (normal 90)) and combined ROM was 220 to 230 degrees (normal 240).  Painful motion was not addressed.  

A physical therapy (PT) evaluation on 2 February 2006, 3 months prior to separation, revealed thoracolumbar forward flexion of 80 degrees and combined ROM of 205 degrees.  Painful motion was present, but gait, posture and spinal muscle spasms were not addressed.  There was no VA examination proximate to separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition at 10%, analogously coded 5299-5237 (lumbosacral strain), citing spinal tenderness.  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 recorded by the MEB NARSUM and PT examinations proximate 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.  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 of 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.

Contended PEB Conditions:  Cervicalgia, Myofasciitis of the Right Medial Scapula, Old Subluxation of Right Tenth Costovertebral Junction and Mild Congenital Abnormalities.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  None of the conditions were profiled or implicated in the commander’s statement.  Only the cervicalgia was judged to fail retention standards by the MEB.  However, there was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions and so no additional disability ratings are recommended.

BOARD FINDINGS:  In the matter of the back condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended cervicalgia, myofasciitis of the right medial scapula, right tenth costovertebral junction and mild congenital abnormalities, the panel recommends no change from the PEB determinations as not unfitting.  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:

Exhibit A.  DD Form 294, dated 20170429 w/atchs
Exhibit B.  Service Treatment Record

AR20180006645, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

	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.

Sincerely,					      
Enclosure