RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04509
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050228

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

CI CONTENTION:  The CI’s condition has worsened and negatively affects his daily activities.  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 – 20050114	VARD – 20050718	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain 	5299-5242	10%	Thoracic Back Pain	5242	10%	20050511	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Back Pain Due.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s back condition began after hard parachute landing falls in 1998 and 2002.  An MRI in August 2004 revealed a possible bulging disk at T7-8.  A thoracic spine CT scan the next month showed multilevel degenerative disc disease.  The 19 November 2004 MEB NARSUM examination, 3 months prior to separation, noted complaints of worsening back pain.  Physical examination showed tenderness.  The range of motion (ROM) study showed flexion of 75 degrees (normal 90) and combined ROM of 175 degrees (normal 240).  Gait was not addressed and reflexes were normal.  

At the 11 May 2005 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported continued pain which occurred daily from the lower thoracic area to the waist and was aggravated by activity.  No assistive device was in use.  Physical examination showed tenderness, but the CI’s gait was normal.  The ROM study showed the CI able to bend forward to touch his toes (approximately 90 degrees).  Rotation was not reported, but combined ROM was at least 175 degrees.  A thoracic MRI showed no significant abnormality, but a lumbar MRI showed multilevel degenerative changes most severe at L5-S1.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, analogously coded 5299-5242 (degenerative arthritis of the spine), citing combined thoracolumbar ROM of 185 degrees.  The VA also rated the back condition 10%, coded 5242, based on the C&P examination, citing X-ray evidence of arthritis.  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 reported on the pre-separation NARSUM 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.  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.

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.  

The following documentary evidence was considered:

AR20180016641, 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.