RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX  	CASE:  PD-2017-05371
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060718

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Computer Systems Journeyman, medically separated for “chronic back pain associated with degenerative disc disease (DDD), L5-S1” with a disability rating of 20%.  

CI CONTENTION:  “I believe that numerous factors were overlooked during the evaluation process.”  The CI also requested review of 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 - 20060424	VARD - 20060807	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Back Pain Associated with DDD, L5-S1	5243	20%	Degenerative Arthritis of Lumbar Spine	5242	10%	20060627	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:  

Chronic Back Pain Associated with DDD, L5-S1.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in 2005 after feeling a “pop” in his lower left back while doing sit-ups.  Lumbar spine MRI on 15 December 2005 showed DDD with a left disc bulge and lateral recess stenosis.  Lumbar spine X-rays were normal without evidence of instability.  

The 30 January 2006 MEB NARSUM examination, 6 months prior to separation, noted complaints of lower back pain.  Physical examination showed a normal gait and stance and there was no crepitus or muscle spasm of the thoracolumbar spine.  Thoracolumbar range of motion (ROM) measurements recorded active flexion of 50 degrees (normal 90) and combined ROM of 200 degrees (normal 240) after repetitive motion, with pain at the end ROM.  There was no surgical intervention recommended at that time.  
At the 27 June 2006 VA Compensation and Pension (C&P) examination, one month before separation, the CI reported pain located at lumbar spine.  Physical examination showed posture and gait to be within normal limits.  The examiner found no evidence of radiating pain on movement.  There was no muscle spasm, ankylosis or tenderness.  There were normal spinal curvatures and no signs of intervertebral disc syndrome (IVDS).  Thoracolumbar ROM was flexion of 80 degrees (normal 90) and combined ROM of 230 degrees (normal 240) after repetition, with pain noted at end ROM.  The VA examiner indicated there were no signs of IVDS with chronic and permanent nerve root impairment.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 20%, coded 5243 (IVDS).  The VA 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.  The panel 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 proximate to separation.  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 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.  

SAF/MRB

Dear XXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05371.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no rating modification or re-characterization of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.