RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX		CASE: PD-2017-05365 BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20060922

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Auxiliary Equipment Technician, medically separated for “degenerative disk 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 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 - 20060613	VARD - 20061013	
Condition	Code	Rating	Condition	Code	Rating	Exam	
DDD	5243	20%	DDD, Post-Operative Laminectomy with Intervertebral Disk Syndrome [IVDS] and Levoscoliosis Lumbar Spine	
5242	
10%	
20060801	
Recurrent Disk Herniation	Cat II					
Chronic Low Back Pain	Cat II					
Lumbar Spondylosis	Cat II					
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

DDD. According to the service treatment record and MEB narrative summary (NARSUM), in January 2005, the CI underwent a micro-diskectomy for a left L5-S1 disk herniation and free fragment. Several months later, he presented with increasingly severe low back pain and radiation to both buttocks. Conservative modalities of treatment were not successful and he had an L5-S1 posterior lumbar inter-body fusion in January 2006. Despite significant improvement, but remained incapable of running, significant lifting, bending, or prolonged sitting.

The 25 May 2006 MEB NARSUM examination, 4 months prior to separation, noted CI complaints of back pain that radiated into the left leg. Physical examination revealed a well-healed lumbar incision, normal gait, and intact lower extremity strength, sensation, and reflexes. Lumbar spine flexion was limited “to approximately 10%.” An X-ray revealed good rod, screw, and spacer placement as well as overall fusion formation.

At the 1 August 2006 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported constant back pain, rated at 6-8/10, that radiated into the left leg and occasionally the right. Physical examination revealed a normal gait and no tenderness, radiating pain on movement, or muscle spasm. Thoracolumbar range of motion (ROM) measurements showed forward flexion limited to 65 degrees (normal 90) and a combined ROM of 170 degrees (normal 240). There was decreased sensation to the left lateral foot and lower leg. Lumbar spine X-rays revealed status post L5-S1 fusion and mild generalized leftward rotatory scoliosis.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the DDD 20%, analogously coded 5243 (IVDS), and listed recurrent disk herniation, chronic low back pain, and lumbar spondylosis as Category II conditions (contribute to the primary unfitting condition but not separately ratable). Panel members agreed that these related diagnoses could not be reasonably justified as separately unfitting; nor would separate ratings be achievable without violation of VASRD §4.14 (avoidance of pyramiding). The VA rated the DDD 10%, analogously coded 5242 (degenerative arthritis of the spine), based on the C&P examination, citing thoracolumbar flexion to 65 degrees and combined ROM of 170 degrees. The panel considered other VASRD back and analogous codes, but all were less applicable and/or not advantageous for rating. There was therefore no higher rating than the 20% adjudicated by the PEB. 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 low back condition.

BOARD FINDINGS: In the matter of the low back condition and IAW VASRD §4.71a, the panel majority 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-2017-05365

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

IN REPLY REFER TO,
1850
CORB: 003
10 Sep 20

From: Director, Secretary of the Navy Council of Review Boards To:	XXXXXXXXXXXXXXX

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.