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

I ll REPLY REFER TO:
1850
CORB: 003
10 Sep 20

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.
1.	
RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:	CASE:  P-2017-05638
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20060810
SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E6, Counter Intelligence Specialist, medically separated for “lumbago” with a disability rating of 20%.
CI CONTENTION: “SNM was separated and several years later still suffered from lower back pain. In 2016 SNM underwent surgery to repair the damaged disk and insert a prosthetic to allow him the ability to walk without pain and discomfort.” 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 - 20060711	VARD - 20070104	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbago	5242-5243	20%	Low Back Musculotendinous Strain due to Rupture of L5-S1 Disk with Sciatica on Left with Scar	
5237	
20%	
20060515	
Lumbar Disk Degeneration	Cat II					
Lumbar Disk Herniation, Status Post Surgery	Cat II					
Lumbar Radiculopathy	Cat II	Radiculopathy, Left Lower
Extremity…	5237-
8520	10%	20060515	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Lumbago. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent a lumbar decompression and discectomy in January 2006. Post- operative radiologic imaging revealed a recurrence of disc bulging of the lumbosacral spine. At the 15 May 2006 VA Compensation and Pension (C&P) examination, 3 months prior to separation, the CI reported continued low back pain (LBP) that extended into his left leg and foot; pain was increased by prolonged sitting, standing and running. The physical examination (PE) revealed a posture and gait described as “good.” Spinal range of motion (ROM) measured forward flexion to 50 degrees (normal 90) and all other directional motion was normal, but painful. Local muscle spasms were in evidence.

The 22 May 2006 MEB NARSUM examination (performed one week after the VA examination) noted complaints of mild LBP as well as “intermittent lumbar radiculopathy”. The symptoms were exacerbated by high impact exercises, carrying heavy loads, climbing, bending, twisting, and torqueing. The PE revealed spinal forward flexion to 50 degrees and combined ROM of 100 degrees (normal 240). Motor strength of both lower extremities was normal and sensation to light touch was decreased in the L-5 neural distribution of the left leg.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the lumbar condition 20%, dual coded 5242-5243 (degenerative arthritis of the spine - intervertebral disc syndrome). The VA also rated the low back condition 20%, under code 5237 (lumbar spine strain), based on the C&P examination, citing objective medical evidence that showed the lumbar spine had a paravertebral muscle spasm. 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 all above referenced examinations. The PEB also listed lumbar disk degeneration and lumbar disk herniation as related diagnoses (Category II) contributing to the disability in this case. The panel concluded that the above two Category II diagnoses were not separate conditions which could be reasonably justified as separately unfitting; nor would separate ratings be achievable without violation of VASRD §4.14 (avoidance of pyramiding).

The PEB also adjudicated radiculopathy as a Category II condition. The CI had herniated discs with radicular pain treated with surgery, and there were symptoms of radiating pain documented in the treatment records; however, examinations indicated normal strength, reflexes and gait, and the sole sensory changes did not affect his job performance. While the CI may have suffered additional pain from the nerve involvement, this is subsumed under the general spine rating criteria, which specifically states “with or without symptoms such as pain (whether or not it radiates).” There was no evidence in this case that motor weakness existed to any degree that could be described as functionally impairing. The panel therefore concluded that an additional disability rating was not justified on this basis. 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 lumbar spine condition.

BOARD FINDINGS: In the matter of the lumbago 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-2017-05638