RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-05227 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20080531

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, SATCOM System Operator/Maintainer, medically separated for “chronic low back pain” with a disability rating of 10%.

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 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 - 20080320	VARD - 20081022	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5243	10%	Osteoarthritis of the Thoracic Spine	5242	10%	20080812	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Low Back Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began insidiously in 2006. Radiographic studies showed degenerative disc disease at L5-S1, but neurosurgery did not recommend surgery. During the  26 February 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported back pain with numbness in the legs after prolonged standing or walking. Physical examination showed tenderness, but no spasm, guarding, abnormal gait or abnormal spinal contour. Goniometric range of motion (ROM) testing showed 95 degrees of flexion (normal 90) and 230 degrees of combined ROM (normal 240). There was no evidence of painful motion. The 27 February 2008 MEB NARSUM examination, 3 months prior to separation, noted complaints of constant 7/10 low back pain, without radiation, that flared to 9/10 with increased physical activity, standing and lifting. The physical examination correlated with the above findings, but noted “moaning, groaning and heavy breathing on low back ROM.”

At the 12 August 2008 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported constant 7-8/10 back pain elicited by physical activity, and stress with

stiffness, weakness and numbness. He denied incapacitation, but noted difficulty with prolonged walking, standing or lifting. Physical examination showed normal gait and posture without spasm, tenderness or ankylosis. The ROM evaluation showed 70 degrees of flexion and 180 degrees of combined ROM limited by pain in all planes of motion. The back was not additionally limited by fatigue, weakness, lack of endurance, or incoordination after repetitive use.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the back condition 10%, analogously coded 5299-5243 (intervertebral disc syndrome (IVDS)), citing tenderness. The VA also rated the back condition 10%, coded 5242 (degenerative arthritis of the spine), 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 235 degrees.

The panel agreed that a 10% rating, but no higher, was justified for limitation of combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on all examinations proximate 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. 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 chronic low back pain 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.

2	PD-2017-05227

ARXXXXXXXXXXX

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.