[AR Number], XXXXXXXXXX. 

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

Dear XXXXXXXXXX:

	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.

Enclosure

RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX.	CASE:  PD-2017-04740
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20080714

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

CI CONTENTION:  Current condition supports a higher rating and an additional unfitting condition was not considered.  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 - 20080229	VARD - 20091027	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Thoracic Lumbar Disc Disease Associated with Chronic Low Back Pain	5243	10%	Degenerative Disc Disease, Thoracolumbar Spine	5243	10%	20090923	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY: 

Thoracic Lumbar Disc Disease associated with Chronic Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in 2005 after falling during a physical fitness run in basic training.  Pain continued with additional training and through a duty assignment.  An MRI showed a T11/12 disk protrusion and minimal L5/S1 protrusion.  Conservative therapy was not effective and the CI was not a surgical candidate. Family practice examinations on 27 August 2007 and 5 September 2007 revealed spinal tenderness, but no muscle spasm.  
The 29 January 2008 MEB NARSUM examination, 6 months prior to separation, noted complaints of chronic back pain.  The examiner documented that the CI walked without apparent discomfort and there was no spinal muscle spasm; tenderness was not addressed.  Thoracolumbar flexion was 90 degrees (normal) and combined ROM was 240 degrees (normal); painful motion was absent.  Spinal X-rays showed slight multilevel degenerative disc changes.

At the 23 September 2009 VA Compensation and Pension (C&P) examination, 14 months after separation, the CI reported severe back pain exacerbated by activity, and with spasms and weakness.  Physical examination showed a normal gait and no back tenderness, spasm, guarding, or weakness.  ROM was flexion to 75 degrees and combined ROM was 225 degrees.  There was painful motion with repetition.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5243 (intervertebral disc syndrome (IVDS)), citing spinal tenderness.  The VA also rated the back condition 10%, coded 5243, based on the C&P examination, citing limited ROM with pain.  Members agreed that while there was insufficient limitation of motion to support a 10% rating proximate to separation, a 10% rating was justified for the sufficient presence of spinal tenderness as adjudicated by the PEB.  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 IVDS 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 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: