RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX	CASE:  PD-2017-05684
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070315

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Human Intelligence Collector, medically separated for “chronic low back pain (LBP)” with a disability rating of 10%.  

CI CONTENTION:  No specific contention was made.  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 - 20070119	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic LBP	5237	10%	 No VA Examination Proximate to Separation in Evidence 	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:  

Chronic LBP.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in July 2003 in a vehicle crash with re-injury in August 2003 with heavy lifting.  X-rays in July 2005 showed lumbarization of the S1 vertebra (congenital anomaly), but MRI was normal.  During the 20 September 2006 MEB and NARSUM examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported LBP brought on by running, jumping, standing for more than 20 minutes, or biking more than 30 minutes.  Physical examination revealed difficulty with dressing, undressing, and bending during the examination.  

The 29 September 2006 physical therapy examination, 5 months prior to separation, noted complaints of back pain and tightness, averaging 5/10 in severity with flares to 8-9/10, which limited walking to 2 miles, running to a half mile, and standing to 30 minutes.  Physical examination showed abnormal spinal curvature (reversed lordosis) and guarding of movement.  Range of motion (ROM) testing showed flexion of 75 degrees (normal 90), extension to 10 degrees (normal 30), lateral flexion to the right and left at 10 and 15 degrees respectively (normal 30), with “negligible rotation” for a combined ROM of 110 degrees (normal 240).  Painful motion was observed.  

During the 2 October 2006 physical medicine appointment, the CI complained of continued LBP.  Physical examination showed tenderness of the spine, and ROM was recorded as extension and lateral flexion to 25% of normal, with no data recorded for flexion or rotation.  Painful motion was again noted.  There was no VA examination proximate to separation in evidence.  The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition at 10%, coded 5237 (lumbosacral strain), citing motion limited by pain and tenderness. 

The panel agreed that the PT examination had the highest probative value for rating at separation and that a 20% rating, but no higher, was justified for guarding severe enough to result in abnormal spinal contour, as reported on the PT examination.  The panel also noted the imprecise “negligible rotation” recorded at that examination, with the consequent implied combined ROM of roughly 105 degrees, which would also reasonably support a rating of 20% for combined ROM of not greater than 120 degrees.  There was 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 recommends a disability rating of 20% for the back condition, coded 5237.  

BOARD FINDINGS:  In the matter of the back condition, the panel recommends a disability rating of 20%, coded 5237 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Low Back Pain	5237	20%	

PD-2017-05684

XXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXX

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs. 

PD-2017-05684