RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04748
BRANCH OF SERVICE:  Army 	 SEPARATION DATE:  20061111

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a National Guard O2, Human Resource Specialist, medically separated for “chronic low back pain” with a disability rating of 0%.   

CI CONTENTION:  Significant daily limitation of motion and low back and hip pain limit his ability to function.  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 - 20060915	VARD - 20040405	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain 	5237	0%	Lumbar Strain	5237	10%	20070227	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Low Back Pain (LBP).  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s LBP initially began while playing tennis during physical training.  He was seen on several occasions in sick call and treated with anti-inflammatory and muscle relaxant medication, but the pain persisted.  In February 2005, an MRI revealed a left paracentral disk extrusion at L5-S1; surgery was not indicated.  

The 18 July 2006 MEB NARSUM examination, 4 months prior to separation, noted CI complaints of continued LBP rated at 5-6/10, without radiculopathy.  Pain increased with prolonged sitting, bending or any strenuous physical activity, but there was no bowel or bladder dysfunction.  He also experienced right intermittent lower extremity tingling while running.  Physical examination (PE) noted full spinal range of motion (ROM) with normal spine curvature, no muscle spasms or localized tenderness, and intact sensation and motor activity.  

At the 27 February 2007 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported being under chiropractic care since his separation, which provided mild relief and improved ROM.  The LBP remained constant, but varied in intensity, and he denied numbness, tingling, motor weakness or loss of bowel or bladder control.  Pain was increased by lifting, twisting, bending, and standing.  The PE revealed a normal gait and the ability to heel and toe walk.  Spinal ROM was normal and non-painful, and localized tenderness was not present.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic LBP condition 0%, coded 5237 (lumbosacral strain), citing a mild condition with full ROM, normal gait, curvature and motion, and no localized tenderness or spasm.  Utilizing the same VASRD code, the VA rated the back condition 10%, based on the C&P examination, citing forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees, or, combined ROM of the thoracolumbar spine greater than 120 degrees but not greater than 245 degrees.  There was no limitation of thoracolumbar spinal motion or painful motion, altered gait/contour or localized tenderness to support a 10% rating under the General Rating Formula for Diseases and Injuries of the Spine.  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 chronic LBP condition.  

BOARD FINDINGS:  In the matter of the chronic low back pain 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:

[AR NUMBER], XXXXXXXXXXXXXXXXXXXX

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Dear XXXXXXXXXXXXXXXXXXXX:

	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.