RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  xxxxxxxxxxxxxxxx	CASE:  PD-2017-05171
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080530

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

CI CONTENTION:  Review of all conditions requested.  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 - 20080428	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbosacral Sprain	5237	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA 	

ANALYSIS SUMMARY:  

Lumbosacral Sprain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s lumbosacral condition began in 2007after performing push-ups while in basic training.  Radiographic imaging showed mild L4-5 disc bulging.  There was no surgical indication.  The 16 April 2008 MEB NARSUM examination, one month prior to separation, noted complaints of dally inconsistent, sharp, achy pain rated 5/10  that increased to 6/10 with a tired achy sensation in the right knee following walking, jogging, bending, twisting, and wearing full combat field equipment.  Physical examination showed a normal gait and tenderness.  Range of motion (ROM) measurements were flexion of 90 degrees (normal) and combined ROM of 230 degrees (normal 240) with painful motion after repetition.  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 lumbosacral condition 10%, coded 5237 (lumbar spine strain), citing normal walk and combined ROM measured as 215 degrees.  The panel noted that the PEB cited the NARSUM combined ROM as 215 degrees, but apparently did not truncate the measurements which exceeded the normal standard for left lateral bending nor did they use ROM measurements after repetition.  IAW VASRD 4.71a Note 2, “The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.” 

The panel agreed that a 10% rating, but no higher, was justified for combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the NARSUM examination one month prior to separation.  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 intervertebral disc syndrome 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 lumbosacral condition.  

BOARD FINDINGS:  In the matter of the lumbosacral 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.  

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Dear xxxxxxxxxxxxxxx:

	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.