RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:	CASE:  PD-	-	7
BRANCH OF SERVICE:  ARMY	SEPARATION DATE: 20060113
SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Information System Operator Analyst, medically separated for “low back pain” 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 - 20051202	VARD - 20060606	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Low Back Pain	5299-5243	0%	Degenerative Disc and Joint Disease, Lumbosacral Spine	5243	20%	20060320	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

Chronic Low Back Pain (LBP). According to the service treatment record and MEB narrative summary (NARSUM), the CI’s LBP began in 1996 while lifting weights, and he underwent physical therapy (PT) intermittently from 1996-2001. In February 2002, he was diagnosed with degenerative disc disease and multiple herniated spinal vertebra, and had spinal surgery in August 2002. However, the back pain did not completely resolve, even after PT and multiple post-operative spinal injections.

The 14 November 2005 MEB examination (recorded on DD Forms 2807-1 and 2808) revealed normal thoracolumbar range of motion (ROM) except for extension measured to 20 degrees (normal 30); painful motion was not present. A day later, the MEB NARSUM examination noted complaints of daily, constant, stabbing back pain that worsened with movement and bending. Pain relief measures included a non-steroidal anti-inflammatory drug, lying down, stretches, elevating the legs and the application of heat.

At the 20 March 2006 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported LBP that occasionally radiated to the right hip. The examiner documented loss of lumbar lordosis with mild paraspinal tenderness, but a normal gait. Spinal flexion was painful and measured to 75 degrees (normal 90) with a combined ROM of 210 (normal 240). Deluca criteria was positive noting an additional decrease in flexion of 15 degrees secondary to increased pain (equating to 60 degrees of spinal flexion).

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the low back condition 0%, analogously coded 5299-5243 (intervertebral disc syndrome), citing no significant loss of spinal motion, radiculopathy, muscle spasm or tenderness. The VA rated the low back condition 20%, coded 5243, based on the C&P examination, citing forward flexion greater than 30 degrees but not greater than 60 degrees. Panel members first acknowledged the difference in spinal ROM values from pre and post separation dates. Although there was no record of recurrent injury or other development to explain the more marked VA ROM impairment, the panel agreed the VA examination carried greater probative value for rating because it provided more detailed physical findings than the MEB examination. Panel members adjudged that that the examiner’s clear notation of positive DeLuca criteria of an additional 15- degree loss with flexion greater than 30 degrees but not greater than 60 degrees warranted a 20% rating. After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20%, coded 5299-5243.

BOARD FINDINGS: In the matter of the low back condition and IAW VASRD §4.71, the panel recommends a disability rating of 20%, coded 5299-5243. 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	5299-5243	20%	

The following documentary evidence was considered:

2	PD-2017-05857

AR20200004361,

DEPARTMENT OF THE ARMY
ARMY REVIEW BOARDS AGENCY 251 18TH STREET SOUTH, SUITE 385
ARLINGTON, VA 22202-3531

Dear	:

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.

Printed on	Recycled Paper