RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04523
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20091126

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Multiple Launch Rocket System Repairer, medically separated for “lumbosacral strain” with a disability rating of 20%.

CI CONTENTION:  No specific contention was made.  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 -20091007	VARD - 20100617	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbosacral Strain	5237	20%	Lumbar Strain	5237	10%	20100222	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:  

Lumbosacral Strain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s low back condition began in 2005 after receiving spinal anesthesia during a knee surgery, which developed into bilateral leg tingling, numbness and decreased sensation.  An MRI in April 2008 showed no abnormalities.  Despite epidural steroid injections, radiofrequency ablation, acupuncture, aqua-therapy, and pain medication, the back pain did not subside.  The 29 July 2009 MEB NARSUM examination, 4 months prior to separation, noted CI complaints of back pain and flare-ups.  Physical examination showed a normal gait and spinal contour, but painful heel and toe walking and tenderness.  Repetitive goniometrically measured thoracolumbar spine flexion was to 85 degrees (normal 90) with a combined range of motion (ROM) of 215 degrees (normal 240); painful motion not addressed.  The examiner opined the CI had an “additional functional impairment of 50%” during flare-ups.

At the 22 February 2010 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported back spasms, decreased motion, weakness, numbness and flare-ups, but denied incapacitating episodes in the past 12 months.  Physical examination showed normal gait and posture, and spinal tenderness without muscle spasms.  Thoracolumbar flexion was to 85 degrees with a combined ROM of 235 degrees, and painful motion.  There was no additional loss of ROM due to pain after repetition.  X-rays showed evidence of degenerative spine changes.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the low back condition 20%, coded 5237 (lumbosacral strain), citing an estimated functional limitation to 45 degrees of flexion during flares.  The VA rated the low back condition 10%, also coded 5237, based on the C&P examination, citing limitation of flexion.  Panel members agreed there was no limitation of thoracolumbar motion to support a higher rating than the 20% adjudicated by the PEB.  There was no documentation of intervertebral disc syndrome with incapacitating episodes that 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 low back condition.  

BOARD FINDINGS:  In the matter of the low 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:

AR20190007304, 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.