RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX  	CASE:  PD-2017-05794
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060503

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an Air National Guard E3, Communications Cable System Apprentice, medically separated for “low back sprain/strain; bulging disc L1-L2 L2-L3 and L3-4” with a disability rating of 0%. 

CI CONTENTION:  Review all conditions.  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 – 20050215	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Lower Back Sprain/Strain...	5237	0%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Lower Back Sprain/Strain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI injured her back in December 1999 after falling from a telephone pole at technical training school.  She was did not receive medical treatment at the time, but was treated for low back pain with medications, physical therapy, steroid facet injections and activity modifications over the years.  Lumbar spine X-rays in May 2000 were normal, but an MRI in April 2001 revealed mild degenerative disc disease at L3-L4. 

The 31 August 2004 MEB NARSUM examination, 20 months prior to separation, noted CI complaints of pain with prolonged sitting, driving, walking, exercising, and when lifting 10-15 pounds.  She described low back muscle pain and cramping, and physical findings noted tenderness but no paraspinal muscle spasms or abnormal gait.  Forward flexion was to 45 degrees (normal 90) and combined range of motion (ROM) was 175 degrees (normal 240), with pain on flexion and extension.  At the time of the updated 30 November 2005 MEB NARSUM examination, 5 months before separation, the CI reported improved pain with stretching exercises, and that she was not taking medication.  On examination, there was tenderness, but no spasms.  The orthopedic examiner recorded flexion to 80 degrees and extension to 10 degrees, with pain, and noted there were “essentially no changes except some increase in flexion” since his 2004 MEB NARSUM.  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 low back condition 0%, coded 5237 (lumbar spine strain).  Panel members agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 60 degrees but not greater than 85 degrees).  There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis.  There was no evidence of intervertebral disc syndrome which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under that alternate formula.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the low back condition, coded 5237.  

BOARD FINDINGS:  In the matter of the lower back condition, the panel recommends a disability rating of 10%, 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	
Lower Back Sprain/Strain	5237	10%	

SAF/MRB

Dear XXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05794.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was not in accordance with the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended modification of your assigned disability rating without re-characterization of your separation with severance pay. 

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding, accept the recommendation and direct that your records be corrected as set forth in the attached copy of a Memorandum for the Chief of Staff, United States Air Force.  This will not result in any change to your separation documents or the amount of severance pay you are entitled to.  Disability severance pay is computed the same regardless of a rating of 0, 10 or 20 percent.