RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05531
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20060630

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Medical Equipment Repair Specialist, medically separated for “chronic low back pain” 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 - 20060426	VARD - 20070712	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5242	10%	Residuals, Low Back Injury with Spondylosis, Disc Disease	5243	0%	20070131	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:  

Chronic Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began sometime in 2001 after a parachute jump.  On 6 March 2006, the CI reported to the emergency room for low back pain on the right side.  Lumbar spine X-rays showed mild small anterior osteophytes of L4 with mild disk space narrowing at L4-L5.  
  
The 21 March 2006 MEB NARSUM examination, 3 months prior to separation, noted complaints of low back pain.  The CI reported the pain was concentrated on the right side of the lower back and was aggravated with heavy lifting.  Physical examination showed normal motor strength, sensation and reflexes.  Gait was normal and straight leg raise (SLR) testing was negative.  Goniometric range of motion (ROM) measurements were active flexion of 90 degrees (normal) and combined ROM of 200 degrees (normal 240).  The CI was diagnosed with chronic low back pain with no evidence of radiculopathy.  

At the 31 January 2007 VA Compensation and Pension (C&P) evaluation, 7 months after separation, the CI reported low back pain with stiffness and lock ups.  The pain occurred one time per month and lasted for 2 weeks.  The pain traveled to the legs and was described as aching, sharp, sticking and shooting in nature.  The CI reported that over the past year, there were three incidents of incapacitation for a total of 24 days.  There was no evidence of incapacitating evidence in the STR.  Physical examination showed the CI with normal spinal contour and gait and no paraspinal muscle spasm or tenderness.  Examination of the thoracolumbar spine revealed no evidence of radiating pain on movement.  There was no ankylosis of the spine.  The ROM study showed flexion of 90 degrees and combined ROM of 240 degrees.  Spinal motion was not additionally limited by pain, fatigue, weakness, lack of endurance or incoordination after repetitive use.  There were no signs of intervertebral disc syndrome with chronic or permanent nerve root involvement.  X-ray findings were within normal limits.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, coded 5242 (degenerative arthritis of the spine), citing combined ROM limited to 200 degrees.  The VA rated the back condition 0%, coded 5243 (intervertebral disc syndrome), based on the C&P examination, citing no appreciable limitation of motion.  The panel agreed that a 10% rating, but no higher, was justified for combined ROM greater than 120 degrees but not greater than 235 degrees, as reported on the MEB examination 3 months proximate to separation.  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 there be 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 20170714, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record  

AR20180007420, 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