RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:	CASE: PD-2017-05927
BRANCH OF SERVICE:  ARMY	SEPARATION DATE: 20070901

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Military Police, medically separated for “chronic low back pain (LBP)” with a disability rating of 0%.

CI CONTENTION: In addition to review for the continued constant back pain, the CI requested review of an additional condition not identified by the Medical Evaluation Board (MEB) and/or Physical Evaluation Board (PEB). 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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20070522	VARD - 20071212	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic LBP	5239	0%	Lumbar Spine Strain/Spondylolysis	5240-5237	10%	20071015	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Chronic LBP. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI suffered persistent LBP after a strain injury in March 2005. A 3 March 2006 CT scan demonstrated spondylolysis (but no significant instability on flexion and extension X-rays) and multilevel degenerative disc disease (L3-S1, no neural compromise). There was no persistent radiculopathy, multiple neurological examinations were normal, and a neurosurgical consultant recommended conservative treatment. Provider entries in the STR documented grossly normal range of motion (ROM), albeit with painful motion, and there were none that indicated any significant ROM limitation. There was ample documentation of a normal gait, a single entry for abnormal contour that was not corroborated by any other examiner, and no documentation of any incapacitating episodes.

The 1 April 2007 MEB NARSUM examination, 5 months prior to separation, noted complaints of constant LBP rated 5/10 on average that limited running, standing longer than 45 minutes, sustained loadbearing, and heavy lifting. The physical examination recorded a normal gait, no note of tenderness, spasm or abnormal spinal contour, and normal neurological findings.

Measured ROM was flexion to 65 degrees (normal 90) and combined ROM of 200 degrees (normal 240), specifying painful motion.

At the 15 October 2005 VA Compensation and Pension (C&P) examination, 6 weeks after separation, the CI reported constant LBP with frequent flares of moderate severity that limited standing to 90 minutes and imposed occupational limitations with lifting and carrying. The examiner documented the absence of any incapacitating episodes. The physical examination recorded a normal gait with no note of abnormal spinal contour, “mild” tenderness, no spasm, and normal neurological findings. Measured ROM was flexion to 80 degrees and combined 215 degrees, specifying painful motion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the lumbar spine condition 0%, coded 5239 (spondylolisthesis or segmental instability), citing reduced flexion limited by pain (likely application of Army Regulation 635-40, B-29, e). The VA rated the condition 10%, coded 5240-5237 (ankylosing spondylitis rated as lumbosacral strain), based on the C&P examination and citing the applicable VASRD §4.71a spine criteria for limitation of flexion and combined ROM (see below). 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/or combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the NARSUM and VA examinations. There was insufficient evidence for muscle spasm or guarding causing an abnormal spinal contour and no abnormal gait to support 20% criteria. 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 10% for the lumbar spine condition, coded 5242 (degenerative arthritis of the spine).

BOARD FINDINGS: In the matter of the lumbar spine condition, the panel recommends a disability rating of 10%, coded 5242 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	
Spondylolysis and Degenerative Disc Disease, Lumbar
Spine	5242	10%	

The following documentary evidence was considered:

2	PD-2017-05927

AR20200004372,

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.

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