SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

MEMORANDUM FOR THE DIRECTOR, AIR FORCE REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on XXXXXXXXXXXXX
	Case Number PD-2018-00060

	In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual from the United States Air Force.  After carefully reviewing the application and medical separation case file, the PDBR recommended no re-characterization of the separation or modification of the disability rating previously assigned.  I recommend you accept this proposed decision.

	The covered individual was an active duty E5, Flight Engineer, medically separated for “chronic low back pain with radiculopathy,” rated 20%, coded 5243 (intervertebral disc syndrome); and “chronic neck pain,” rated 0%, coded 5241 (spinal fusion), with a combined disability rating of 20%.  The VA rated the back condition 10%, coded 5243, based on the Compensation & Pension (C&P) examination, citing limitation of flexion.  The panel agreed that the determinant probative value should be assigned to the C&P evidence.  It was temporally closer to separation and the ROM measurements, which supported a 10% rating, were more consistent with the overall evidence.  The panel also considered whether additional service rating could be recommended for the residual radiculopathy, but noted no objective neurological deficit in evidence.  There was thus neither the functional link to fitness requisite for service rating nor the presence of a VASRD ratable deficit.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a 10% rating for the back condition under code 5242 (degenerative arthritis of the spine).     

	The VA rated the neck condition 20%, coded 5243, based on the C&P examination, citing limitation of flexion.  Although the post-separation C&P evidence was more temporally probative and more VASRD compliant, there was considerable probative value mitigation by the significant conflict between the reported acuity in the service versus that reported to the VA rating examiner.  The service treatment record evidence was well corroborated, and jpanel members agreed that (more likely than not and overcoming reasonable doubt) the acuity reflected by the C&P examination was not present at separation.  The panel thus agreed that the determinant probative value should be assigned to the service evidence, and that the single data point for flexion just meeting the 20% threshold from the C&P examination was insufficient to serve as the basis for its recommendation.  Therefore, the panel agreed that a 10% rating, but no higher, was justified for painful motion of the neck.  After due deliberation, considering all the evidence and with deference to reasonable doubt, the panel recommends a 10% rating for the neck condition under code 5241.  As the proposed new combined disability ratings result in no change to the combined disability rating previously assigned, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.

	

SAF/MRB
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

Dear XXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2018-00060

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.