RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX  	CASE:  PD-2017-05695
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080127

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E1, Broadcast Journalist, medically separated for “lumbar degenerative disc disease” with a disability rating of 10%.  

CI CONTENTION:  “My back issues that were caused by military service have prevented me from working…”  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 - 20071030	VARD - 20080516	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lumbar Degenerative Disc Disease 	5299-5242	10%	Degenerative Disc Disease, Lumbosacral Spine	5242	10%	20080417	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Lumbar Degenerative Disc Disease (DDD).  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s back condition began in July 2004 with no specific injury or trauma.  An MRI on 9 July 2007 revealed multi-level DDD and facet osteoarthritis.  At the physical therapy (PT) appointment for MEB range of motion (ROM) measurements, 8 months prior to separation, the CI complained of back pain rated at 6/10.  The examiner noted a normal gait, localized tenderness and no guarding with motion; ROM was recorded as flexion of 50 degrees (normal 90) and combined ROM of 180 degrees (normal 240).  

The 17 July 2007 MEB NARSUM examination, 6 months before separation, noted complaints of constant back pain with occasional radiation down the left leg as well as numbness and tingling.  The CI also endorsed low back stiffness and frequent muscle spasms.  The physical examination (PE) revealed tenderness and muscle spasms about the lumbar spine.  Motor activity, sensation and peripheral reflexes were normal.  

At the 17 April 2008 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported low back pain which extended into both legs, left greater than right.  The PE revealed normal posture, gait and spinal contour.  Thoracolumbar ROM was decreased and painful with forward flexion to 80 degrees and combined ROM of 205 degrees.  Spinal tenderness without spasm was present.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the back condition 10%, analogously coded 5299-5242 (degenerative arthritis), citing localized tenderness/spasm and ROM limited by pain.  Utilizing the same primary code, the VA also rated the back condition 10%, based on the C&P examination, citing forward painful and reduced ROM.  The panel agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 60 degrees but not greater than 85 degrees) and combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the more probative VA examination.  The examinations noted the presence of muscle spasm, however it was not severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% 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 low 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 no modification or re-characterization of the CI’s disability and separation determination. 

	PD-2017-05695

XXXXXXXXXXXXXXX 

Dear XXXXXXXXXXX

	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.

	PD-2017-05695