RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  xxxxxxxxxxxxx.  	CASE:  PD-2017-04486
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080406

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Infantryman, medically separated for “chronic low back pain” with a disability rating of 20%.  

CI CONTENTION:  “Review all conditions.”  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 USAPDA - 20080415	VARD - 20080617	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5237	20%	Bulging Disc, L4-5 	5237	10%	20080130	
Hearing Loss	Not Unfitting	Right Ear Hearing Loss	6100	NSC	20080117	
		Left Ear Hearing Loss	6100	NSC	20080117	
Headaches	Not Unfitting	Migraine Headaches	8100	10%	20080130	
Plantar Fasciitis	Not Unfitting	Bilateral Plantar Fasciitis	5276	0%	20080130	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in January 2007 during physical therapy (PT) when he felt a pop in his back.  Radiographic studies showed lumbar spine straightening, likely due to muscle spasms, and minimal degenerative changes.  Electrodiagnostic studies were normal.  

The 25 October 2007 MEB NARSUM examination, 6 months prior to separation, noted complaints of persistent lumbar pain.  Prolonged sitting or staying in one position for any length of time caused pain as did lifting anything greater than 30 pounds.  Goniometric range of motion (ROM) testing showed forward flexion of 50 degrees (normal 90) and combined ROM of 180 degrees (normal 240).  Limitation of motion was secondary to pain.  On examination, tenderness and muscle spasms were present, but the gait was normal and there was no abnormal spinal contour noted.  

At the 30 January 2008 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI complained of worsening back pain.  Physical examination showed tenderness but no ankylosis was noted.  The ROM study showed flexion of 70 degrees and combined ROM of 200 degrees.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, coded 5237 (lumbosacral strain), citing forward flexion of 55 degrees.  The VA rated the back condition 10%, coded 5237, based on the C&P examination, citing forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees.  

The panel agreed that a 20% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 60 degrees) reported on the NARSUM examination.  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 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:  Hearing Loss, Headaches and Plantar Fasciitis.  The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting.  The headaches and plantar fasciitis conditions were not profiled, but the hearing loss was.  None of the contended conditions were implicated in the commander’s statement or judged to fail retention standards.  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, 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 hearing loss, headaches and plantar fasciitis, 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:

[AR Number], XXXXXXXXXXXXXX. 

Dear  XXXXXXX:

	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.
 
	A copy of this decision has been provided to the counsel you listed on your application; [name and address].