RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-05385 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20070315

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Logistics Vehicle Systems Operator, medically separated for “isthmic spondylolisthesis L4-L5 and associated foraminal stenosis and degenerative disk disease [DDD] at L4-L5 associated with 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 - 20070125	VARD - 20071011	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Isthmic Spondylolisthesis L4-L5…and DDD at L4-L5	5241	10%	

Spinal Fusion, L4-5	

5241	

10%	

20070508	
Status Post (S/P) Transforaminal
Lumbar Interbody Fusion, L4-L5	Cat II					
S /P Grafting with Local Autograft Supplement with Bone Morphogenic
Proteins	Cat II					
S/P Posterior Instrumentation, L4-L5	Cat II					
S/P Gill Decompression L4	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Isthmic Spondylolisthesis and DDD. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent an L4-L5 spinal fusion in June 2006 for spondylolisthesis (disc slippage). Despite restrictions and physical therapy, the back pain did not completely resolve. The 15 December 2006 MEB NARSUM examination, 3 months prior to separation, noted complaints of back pain, and the inability to run for an extended amount of time. The physical examination (PE) revealed tenderness along the lumbar paraspinal muscles, and measured ROM showed forward flexion to 85 degrees (normal 90) with a combined ROM of 190 degrees (normal 240). A 3 January 2007 ROM evaluation, 2 months before separation, recorded thoracolumbar

flexion to 90 degrees and combined ROM was 190 degrees. At the 8 May 2007 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported constant back pain aggravated by bending. The PE revealed a normal gait and flexion to 85 degrees, extension to 10 degrees (normal 30), and a combined ROM of 215 degrees, with painful motion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the low back condition 10%, coded 5241 (spinal fusion), and also listed the Category II (contribute to the primary unfitting conditions but no separately ratable) conditions found in the chart above. Panel members agreed that the impairment from these related diagnoses were properly subsumed under the overall rating for the spondylolisthesis IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The VA also rated the low back condition at 10%, coded 5241, based on the C&P examination, citing thoracolumbar flexion 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 tenderness, limitation of flexion or combined ROM, and painful motion, as documented on the NARSUM and VA 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. There was also 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 low back condition.

BOARD FINDINGS: In the matter of the low 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:

2	PD-2017-05385

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE 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 Sep20

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

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.