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

MEMORANDUM FOR THE DIRECTOR, ARMY REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on XXXXXXX
	Case Number PD-2019-00095

	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 (CI) from the United States Army.  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 CI was an active duty E5, Military Policeman, medically separated for “chronic back pain…without significant neurologic abnormality” with a disability rating of 10%.  The PEB rated the back condition 10%, coded 5243 (intervertebral disc syndrome (IVDS)), citing tenderness, no significant neurologic abnormality, and combined thoracolumbar range of motion (ROM) greater than 240 degrees.  The VA also rated the back condition 10%, analogously coded 5299-5242 (degenerative arthritis of the spine) based on the Compensation and Pension examination, citing the applicable criteria.  

A 10% rating, but no higher, was justified for limitation of flexion greater than 60 degrees but not greater than 85 degrees or combined ROM greater than 120 degrees but not greater than 235 degrees, as reported on the  all examinations proximate to separation.  Although the PEB cited the combined ROM as greater than 235 degrees, apparently it did not truncate the measurements which exceeded the normal standard for rotation and lateral bending.  However, IAW VASRD 4.71a Note 2, “the normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.”  There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis, and there was no documentation of IVDS with incapacitating episodes which would provide for a higher rating under that alternate formula.  While the CI may have suffered additional pain from the nerve involvement, this is subsumed under the general spine rating criteria, which specifically states “with or without symptoms such as pain (whether or not it radiates).”  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 back condition.  

AR20230000848, 

Dear XXXXXXXXXX:

	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,