RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05632
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080117

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Motor Transport Operator, medically separated for “lumbosacral strain” with a 10% disability rating.  

CI CONTENTION:  “I feel that the rating that I was given at my original PEB board was rushed due to my base closing in Germany.”  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 - 20071004	VARD - 20080227	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbosacral Strain 	5237	10%	Lumbosacral Strain	5299-5243	10%	20080103	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Lumbosacral Strain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI experienced a gradual onset of low back pain, without injury or trauma, in October 2006, with numbness and tingling into the lower extremities.  An MRI and X-rays in late 2006 indicated L-5 spondylolysis with minimal slippage of L-5 on S-1.  

During the 26 July 2007 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, she reported low back pain with progressively worsening numbness and tingling into the legs, feet and toes, and the physical examination (PE) revealed normal, but painful thoracolumbar motion.  The 15 August 2007 MEB NARSUM neurosurgery consult, conducted 5 months before separation, noted CI complaints of low back pain with intermittent numbness extending into both legs.  The PE recorded thoracic and lumbar tenderness and a gait “without a limp."  Peripheral muscle strength was normal, and sharp and dull sensation was decreased in the L-5 nerve distribution on the right lower extremity.  There was “moderately restricted range of motion” with flexion and extension. 
At the 29 August 2007 MEB NARSUM examination, the CI complained of constant, sharp and non-radiating mid to low back pain, and occasional numbness along the back of calves extending down to the heels.  She had trouble lifting, throwing, maneuvering stairs, running, and reaching for objects above shoulder level.  The PE noted a normal gait and spinal tenderness with painful lumbosacral ROM “decreased in all planes,” but no functional loss.  Light touch sensation was decreased in both lower extremities from the inside of the ankles to the back of the knees, and peripheral strength was normal.  Repeat radiographs continued to show the prior L-5 spondylolysis as well as degenerative changes. 

At the 3 January 2008 VA Compensation and Pension (C&P) examination, 2 weeks prior to separation, the CI reported constant low back pain with stiffness and weakness that was aggravated by physical activity and relieved by medication; she denied any incapacitating episodes.  The PE revealed a normal gait and spinal curvature with no extending pain or spasm upon movement.  Spinal tenderness was present, and measured thoracolumbar ROM revealed flexion to 75 degrees (normal 90) and painful combined ROM of 175 degrees (normal 240).  Spine motion and function was additionally limited 10 degrees by pain, fatigue, weakness, and lack of endurance after repetition; there were no signs of intervertebral disc syndrome (IVDS).  
 
The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the low back condition 10%, coded 5237 (lumbar spine strain), citing pain limited motion.  The VA also rated the low back condition 10%, but analogously coded 5299-5243 (IVDS, based on the C&P examination, citing painful motion.  Panel members agreed that the VA examination, which was closest to separation, clearly supported a 10% rating based on the combined ROM.  Additionally, there was no muscle spasm or guarding to cause an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis.  Additionally, there was no documentation of IVDS with incapacitating episodes which would provide for a higher rating under that formula, or evidence of ratable peripheral nerve impairment which would provide for additional rating.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that 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.  

ARXXXXXXXXXXX, XXXXXXXXXXXX

Dear XXXXXXXXXXXX:

	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.