RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05229
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070729

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Wheeled Vehicle Mechanic, medically separated for “retrolisthesis [a condition in which spinal vertebrae become displaced and move backwards] at L4-5 and L5-S1” with a disability rating of 10%.   

CI CONTENTION:  The CI made no specific contention.  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 - 20070525	VARD - 20071128	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Retrolisthesis L4-5 and L5-S1	5299-5239	10%	Degenerative Disc Disease, Lumbar Spine	5237	0%	20070918	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:  

Lumbosacral Spine Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition gradually began in 2004.  X-ray studies revealed vertebral slippage of the lumbosacral spine as well as spinal disc abnormality of the lumbar vertebrae extending from L1 to L4 causing mild stenosis of the corresponding spinal canal.  There was no indication for surgical intervention.  During the 21 September 2006 neurological examination, 10 months prior to separation, the examiner recorded the CI had a normal gait and the spine was normal to inspection, palpation and range of motion (ROM).  

Both the 30 March 2007 MEB NARSUM examination and MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, noted complaints of continued low back pain which was aggravated by activity.  The CI endorsed the inability to bend, stoop or squat repetitively.  His physical examination (PE) noted thoracolumbar spine ROM as forward flexion to 75 degrees (normal 90) and a combined ROM of 215 degrees (normal 240).  Tenderness was present over the lumbosacral spine and its surrounding muscle mass.  Strength, motor activity, sensation, and pulses were normal or intact to the lower extremities.  

At the 18 September 2007 VA Compensation and Pension (C&P) evaluation, 2 months after separation, the CI reported low back pain and periodic right leg/foot tingling.  His PE was clinically detailed and completely normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition at 10%, analogously coded as 5239 (spondylolisthesis or segmental instability), citing tenderness and ROM limited by pain.  The VA rated the back condition at 0%, coded 5237 (lumbar spine strain), based on the C&P examination 2 months after separation, citing forward flexion of the thoracolumbar spine greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 235 degrees.

The panel agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 60 degrees but not greater than 85 degrees) and combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the  MEB examinations.  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 of 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 back 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:

Exhibit A.  DD Form 294, dated 20170515, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180007370, 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