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 XXXXXXXXXXXXXX
	Case Number PD-2018-00201

	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 (CI) was an active duty E4, Fuels Journeyman, medically separated for “chronic low back pain secondary to facet disease” with a disability rating of 10% which the PEB coded 5237 (lumbosacral strain).  The VA also rated the low back pain 10%, dual coded 5243-5237 (intervertebral disc syndrome (IVDS)-lumbosacral strain), based on the Compensation and Pension examination, citing pain as well as “muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or spinal contour.”  The preponderance of examinations in evidence documented satisfactory evidence of painful motion IAW VASRD §4.59 to support a 10% rating.  Alternatively the narrative summary and other examination also documented tenderness supporting the 10% rating.  The panel noted that the range of motion (ROM) findings documented by the September 2004 and June 2005 neurosurgery examinations indicated onset of back pain at 50 degrees of flexion which did not equate to limited active flexion of 50 degrees.  The panel therefore placed the greatest probative value for ROM measurements on the July 2006 VA examination which was more detailed, used goniometric ROM measurements in compliance with VASRD §4.46, and documented painful motion and DeLuca Factor considerations.  The panel considered alternative VASRD spine and analogous codes, but all were less applicable and/or not advantageous for rating.  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 pain condition.

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-2018-00201.

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.