RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05000
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080302

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Wheeled Vehicle Mechanic, medically separated for “lumbar degenerative disc disease [DDD]” 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 PEB - 20080305	VARD - 20080528	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbar DDD	5299-5242	20%	Lumbosacral Strain	5237	10%	20080205	
Knee Pain	Not Unfitting 	Retropatellar Pain Syndrome, Right Knee	5299-5261	0%		
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Lumbar DDD.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s spinal condition began in September 2003 without trauma or injury.  Diagnostic radiology tests revealed mild DDD of the lower spine without nerve compression.  At the 24 October 2007 physical therapy appointment, 4 months prior to separation, the CI complained of low back pain.  The physical examination (PE) recorded a normal gait and spinal posture, but tenderness and spasm were present.  Range of motion (ROM) testing showed flexion of 55 degrees (normal 90) and combined ROM of 180 degrees (normal 240) with pain limited motion.  The 7 December 2007 MEB NARSUM examination, 3 months prior to separation, noted complaints of low back pain aggravated by prolonged marching and sitting.  The PE revealed tenderness in various locations on the back, but gait was normal.

At the 5 February 2008 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported daily low back pain which radiated into the left leg with occasional numbness (three to four times per month).  His PE showed normal ROM of the thoracolumbar spine.  There was no tenderness or spasm of the back and posture and gait were normal.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, coded 5299-5242 (analogous to degenerative arthritis of the spine), citing limitation of motion.  The VA rated the back condition 10%, coded 5237 (lumbosacral strain), based on the C&P examination, citing “X-ray findings of spondylosis with multiple involvement of the vertebrae.”  Panel members agreed the VA examination held the greatest degree of probative value due to its proximity to separation.  After due deliberation and based on the most probative objective findings, the panel agreed that the normal physical finding did not support any positive impairment rating.  There was no documentation of intervertebral disc syndrome with incapacitating episodes which would provide for a higher rating under that formula.  However, IAW DoDI 6040.44, the panel may not recommend a rating lower than that received prior to application.  Therefore, 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’s adjudication for the back condition.  

Contended PEB Condition: Knee Pain.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that the condition 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 the contended condition, so no additional disability rating is 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 knee condition, the panel agrees it cannot recommend it for additional disability rating.  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. 

XXXXXXXXXXXXXXXXXX

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.

Sincerely,					      
Enclosure