RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-05125 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20050610

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Dental Technician, medically separated for “chronic low back pain” with a disability rating of 10%.

CI CONTENTION: Review requested of the low back condition, which continues to worsen, as well as additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB). 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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 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 - 20050413	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5243	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Chronic Low Back Pain (LBP). According to the service treatment record and MEB narrative summary (NARSUM), the CI was initially seen in 2004 with a history of chronic back pain without any specific injury or trauma, and attributed his LBP primarily to bending at the waist during dental technician duties. A lumbosacral spine MRI in December 2004 revealed mild degenerative changes and bulging at the L4-5 disc level without nerve root impingement.

The 19 January 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of LBP which did not radiate to the lower extremities. Physical examination revealed tenderness, but a normal gait and spinal contour as well as 5/5 motor strength. Measured range of motion (ROM) showed flexion of 60 degrees (normal 90) and combined ROM of 180 degrees (normal 240). At the MEB examination (recorded on DD Forms 2807-1 and 2808), 1 week later, the CI reported LBP, and the examiner noted tenderness. Orthopedic consultation on 15 March 2005 noted complaints of progressive LBP with bilateral leg pain and symptoms. Examination revealed a normal gait and station with “moderate decreased” lumbar spine ROM, and X-rays and MRI documented degenerative disc disease at L4-5 with a left lateral disc protrusion in the foramen,

but no significant neural compression. Physical therapy and an epidural steroid injection was recommended at a follow-up visit on 28 March 2005. There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the low back condition 10%, analogously coded 5299-5243 (intervertebral disc syndrome (IVDS)). Panel members agreed that a 20% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 60 degrees) as reported on the NARSUM examination. 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 recommends a disability rating of 20% for the low back condition, coded 5299-5243.

BOARD FINDINGS: In the matter of the low back condition, the panel recommends a disability rating of 20%, coded 5299-5243 IAW VASRD §4.71a. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Low Back Pain	5299-5243	20%	

The following documentary evidence was considered:

2	PD-2017-05125

DEPARTMENT OF THE NAVY
SECRETARY OF nm NAVY COUNCIL OF REVIEW BOARDS
720 KENNON STREET SE STE 309 WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO:
1850
CORB:003
12 Oct 20

From: To:

Subj:

Ref:

Director, Secretary of the Navy Council of Review Boards 

PHYSICAL DISABILITY BOARD OF REVIEW {PDBR)

{a) DoDI 6040.44
{b) PDBR ltr of 23 Dec 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy for appropriate action.

2.	On 7 October 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) took action in your case by accepting the recommendation of the PDBR. Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEB) from 10% to 20% without re-characterization of your discharge.

3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, has been forwarded to the Navy Personnel Command for appropriate changes to your personnel records and notification to you upon completion.