RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXX	CASE: PD-2017-05968
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20070807

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Military Policeman, medically separated for “chronic thoracic back pain due to degenerative disc disease [DDD]” with a disability rating of 10%.

CI CONTENTION: “My discharge was very hurried and I feel as if I didn’t get a thorough exam upon exiting. I was never evaluated for PTSD. My conditions have gotten worse since discharge and have negative impact on my activities of daily living.”

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 - 20070604	VARD - 20080603	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Thoracic Back Pain…	5299-5242	10%	DDD	5242	0%	STR	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Chronic Thoracic Back Pain. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s insidious, chronic back condition began in 2003 while deployed to Iraq. Thoracic X-rays in March 2006 showed spondylolysis, and an MRI in July 2006 showed multilevel T6-T12 DDD. At a neurosurgery evaluation on 31 August 2006, the CI reported neck and mid-thoracic spine pain with right lower extremity tingling while running, but no arm pain. Physical examination recorded a normal gait and thoracic spine tenderness. Motor strength was 5/5  in  all  extremities  and  sensory  testing  was  intact.     There  was  no  myelopathy     (spine

compression injury or defect) noted, and the provider determined he was not a good surgical candidate. During the 27 April 2007 MEB NARSUM examination, 3 months prior to separation, the CI reported upper back pain aggravated by pushing, lifting and raking. Physical examination revealed thoracic spine tenderness and normal, bilateral upper arm, forearm and wrist motor strength. Bilateral elbow and wrist deep tendon reflexes were 1+ and sensory testing was normal. Goniometrically measured thoracolumbar flexion was to 80 degrees (90 normal) and combined ROM was 200 degrees (normal 240), with painful motion. 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 back condition 10%, analogously coded 5299-5242 (degenerative arthritis of the spine), citing pain-limited motion with localized tenderness. The VA rated the back condition 0%, coded 5242, based on the STR, citing a lack of evidence. 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) and/or combined ROM (greater than 120 degrees but not greater than 235 degrees), as reported on the MEB NARSUM examination proximate to separation. There was no muscle spasm 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 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 concluded that there was insufficient cause to recommend a change in the PEB adjudication for the chronic 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-2017-05968

ARXXXXXXXXXXX, XXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXX

	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.

Sincerely,					      

Enclosure

PD-2017-05968