RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXX BRANCH OF SERVICE: MARINES
CASE NUMBER: PD0900516 BOARD DATE: 20100630
SEPARATION DATE: 20080430
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SUMMARY OF CASE: This covered individual (CI) was LCPL/E-3, 3531/Motor Vehicle Operator medically separated from the Marine Corps in 2008 after over 2 years of active service and a combined total of over 5 years service. The medical basis for the separation was Lumbago.
The Lumbago was determined to be medically unacceptable. The CI was referred to the PEB, determined unfit for the Lumbago condition, and separated at 10% disability using the Veterans Affairs Schedule for Ratings Disabilities (VASRD) and applicable Navy/Marine Corps and Department of Defense regulations.
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CI CONTENTION: The CI states: “USMC never diagnosed me with Ear problems or PTSD my back has gotten worse”.
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RATING COMPARISON:
| Service PEB | VA (6 Days after Separation) | |||||||
|---|---|---|---|---|---|---|---|---|
| Condition | Code | Rating | Date | Condition | Code | Rating | Exam | Effective |
| Lumbago | 5237 | 10% | 20080114 | Lumbar Disc Degeneration Claimed as Lower Back Condition (Spine) | 5237 | 10% | 20080505 | 20080418 |
| Not in DES | Post Traumatic Stress Disorder | 9411 | 30% | 20080616 | 20080418 | |||
| MEB H&P 20071015 | Tinnitus | 6260 | 10% | 20080516 | 20080418 | |||
| 1 Non-MEB condition NSC | ||||||||
| TOTAL Combined: 10% | TOTAL Combined (Includes Non-PEB Conditions): 40% from 20080418 |
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ANALYSIS SUMMARY:
Lumbago
The CI developed low back pain while working as a truck machine gunner in Iraq. The low back pain (LBP) persisted despite appropriate treatment. He underwent physical therapy, massage, chiropractic treatments, and injections in his spine, and nothing appeared to alleviate his symptoms. He had difficulty driving any long distances and complained of right leg symptoms and pain radiating down his right leg all the way to his toes. Multiple Magnetic Resonance Imagings (MRIs) showed no evidence of disc herniation or any nerve root impingement at any level. Mild degenerative changes were present at the L3-L4 level. Evaluation by two neurosurgeons, Dr. S. in Providence and Dr. F. of Boston, determined that surgical treatment was not indicated.
The CI complained of LBP and right leg pain with radiation down to his toes and occasional numbness but no weakness. His military narrative summary (NARSUM) examination stated he had no true motor weakness but no sensory or reflex examination was documented. The Veterans Administration (VA) Compensation & Pension (C&P) examination documented slightly decreased (4/5) strength throughout the right lower extremity and decreased sensation to pinprick, light touch, and position sense in the right lower extremity. Normal reflexes were documented. The sensory deficit did not follow a dermatomal pattern.
(Separation Date: 20080430)
Movement Thoracolumbar |
Normal ROM | ROM Mil 20071127 (5 months prior to separation) |
ROM VA 20080505 (6 days after separation) |
ROM VA PAIN 20080505 |
|---|---|---|---|---|
| Flex | 0-90 | 70 | 0-90 | 60 |
| Ext | 0-30 | 20 | 0-30 | No pain |
| R Lat flex | 0-30 | 40 | 0-30 | No pain |
| L lat flex | 0-30 | 40 | 0-30 | No pain |
| R rotation | 0-30 | 0-30 | No pain | |
| L rotation | 0-30 | 0-30 | No pain | |
| COMBINED | 240 | 240 | 210 | |
| Notes: | No true motor weakness; no sensory exam or DTRs documented. | Right LE motor 4/5 throughout; decreased sensation ½ Right LE to pinprick, light touch and position; DTR 2+ equal bilateral; No EMG/NCV testing |
Other Conditions
Tinnitus
No evidence this condition was unfitting at the time of separation from service. This condition did not prevent the CI from performing required duties and no duty restrictions are attributed to this condition.
Other Conditions not in Disability Evaluation System (DES)
Post Traumatic Stress Disorder (PTSD)
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BOARD FINDINGS: IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the Physical Evaluation Board (PEB) will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication. After careful consideration of all available information the Board unanimously determined that the CI’s condition is most appropriately rated at 20% under 5237 Lumbago IAW the VASRD General Rating Formula for Diseases and Injuries of the Spine.
Ratings for diseases and injuries of the spine are based on limitations of the range of motion of the spine and the symptom of pain, whether or not it radiates. The CI’s thoracolumbar flexion was limited by pain to 60 degrees and this warrants a 20% rating. There was no evidence of radiculopathy as a cause of the slightly decreased strength and decreased sensation noted on the VA C&P exam and therefore no rating for radiculopathy can be applied.
The Board also considered Tinnitus and unanimously determined that this condition was not unfitting at the time of separation from service and therefore no rating is applied. There were no duty restrictions related to this condition and this condition did not interfere with performance of any required duties.
The other diagnosis rated by the VA (PTSD) was not mentioned in the DES package and is therefore outside the scope of the Board. The CI retains the right to request his service Board of Correction for Naval Records (BCNR) to consider adding these conditions as unfitting.
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RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical separation.
| UNFITTING CONDITION | VASRD CODE | RATING |
|---|---|---|
| Lumbago | 5237 | 20% |
| COMBINED | 20% |
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The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20090827, w/atchs.
Exhibit B. Service Treatment Record.
Exhibit C. Department of Veterans' Affairs Treatment Record.
Deputy Director
Physical Disability Board of Review
MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS
Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATION
ICO XXXXX, EX-USMC, XXX XX XXXX
Ref: (a) DoDI 6040.44
Encl: (1) PDBR ltr dtd 8 Jul 10
1. I have reviewed the subject case pursuant to reference (a) and approve the recommendation of the Physical Disability Board of Review (enclosure (1)).
2. The subject member’s official records are to be corrected to reflect the following disposition:
a. Separation from the naval service due to physical disability rated at 20 percent (increased from 10 percent) effective 30 April 2008.
3. Please ensure all necessary actions are taken to implement this decision, including the recoupment of previously paid funds if appropriate, and notification to the subject member once those actions are completed.
Principal Deputy
Assistant Secretary of the Navy
(Manpower & Reserve Affairs)
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