RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05862
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070813

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Aircraft Armament Systems Craftsman, medically separated for “low back pain” with a disability rating of 20%. 

CI CONTENTION:  The condition continues to worsen.  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 - 20070531	VARD - 20080319	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Low Back Pain	5243	20%	Degenerative Disc Disease, Lumbar Spine	5243	20%	20071204	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Low Back Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent an L5-S1 laminectomy and left interbody fusion on 16 January 2007.  Post-operative STR entries noted an uncomplicated recovery with normal neurological findings and no documentation of incapacitating episodes.   The 20 March 2007 NARSUM examination, 2 months after surgery and 5 months prior to separation, noted improved symptoms since surgery, but continued persistent pain that prohibited running, prolonged sitting/standing and heavy lifting.  The physical examination recorded a normal gait, tenderness without note of spasm, and no neurological deficits.  Range of motion (ROM) measurements revealed flexion to 40 degrees (normal 90) and combined ROM of 135 degrees (normal 240).

The 4 December 2007 VA Compensation and Pension (C&P) examination, 11 months after surgery and 4 months after separation, documented constant low back pain, rated at 5-6/10, without elaboration of functional limitations and no note of incapacitating episodes.  The physical examination recorded a normal gait and spinal contour, tenderness, no spasm, and normal neurological findings except for a sensory deficit on the dorsum of the left foot.   Measured ROM showed flexion to 45 degrees and combined ROM of 175 degrees.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the low back condition 20%, coded 5243 (intervertebral disc syndrome).  The VA conferred the same rating under the same code, based on the C&P examination, citing limitation of motion.  Panel members 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 in the NARSUM and VA examinations.  There was no VASRD spine criterion in evidence that would support a higher rating, and no documentation of 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 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 low 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.  

SAF/MRB

Dear XXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05862.

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 appropriate.  Accordingly, the Board recommended no rating modification or re-characterization of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.