RECORD OF PROCEEDINGS
                     PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXX                                  BRANCH OF SERVICE:  ARMY
CASE NUMBER:   PD1000080                                  SEPARATION
DATE:  20011108
BOARD DATE:  20110727


SUMMARY OF CASE:  Data extracted  from  the  available  evidence  of  record
reflects that this covered individual (CI) was an active duty SGT/E-5  (55D,
Explosive Ordnance Disposal) medically separated for chronic low  back  pain
(LBP).  The CI injured his back in 1999 after a  twisting  injury.   He  was
treated, but did not  respond  adequately  to  fully  perform  his  military
duties or meet physical  fitness  standards.   He  was  issued  a  permanent
profile and underwent a Medical Evaluation Board (MEB).  The  LBP  condition
was  forwarded  to  the  Physical  Evaluation  Board  (PEB)   as   medically
unacceptable IAW AR  40-501.   The  PEB  found  the  chronic  LBP  condition
unfitting and rated it 10%, with application of DoDI 1332.39 and AR  635-40.
 The CI accepted the PEB findings, and  was  medically  separated  with  10%
disability  IAW   the   Veterans’   Administration   Schedule   for   Rating
Disabilities (VASRD) and applicable Army and DoD regulations.


CI CONTENTION:  “After being medically separated from the Army for  my  back
condition (10%), I believe that I was  given  the  lowest  rating  for  this
injury.  As a patient  continuing  treatment,  my  assessment  for  my  back
condition is diagnosed differently due  to  the  VA's  finding  and  medical
treatment.  I would like the Physical Disability  Board  of  Review  to  re-
evaluate my case.  The MRB in 2001 evaluated  me  with  lumbosacral  strain.
The Department of Veterans Affairs  evaluated  me  with  degenerative  joint
disease with right lower extremity neuralgia effective in September 2004.”


RATING COMPARISON:

|Army PEB – dated 20010712     |VA (8 mo. After Separation) – All        |
|                              |Effective 20011109                       |
|Condition                     |Code                            |Rating  |
|Final Combined:  10%          |Total Combined:  60%                     |


ANALYSIS SUMMARY:

Low Back Pain.  The CI had a twisting injury of his back in  November  1999.
Following the injury, he had low back pain, which radiated  into  the  right
leg.  In February 2000, he underwent L5-S1 diskectomy  and  hemilaminectomy.
His surgery was successful, and completely resolved his  radicular  symptoms
in the right leg.  Over the course of several  months,  his  low  back  pain
gradually returned, without any pain or other  symptoms  in  the  legs.   He
underwent physical therapy and had good results.  However, he was unable  to
fully perform his required military duties, and  was  unable  to  meet  Army
physical fitness standards.  His pain was mostly in the morning,  and  after
physical exertion.  The CI was examined at Fort Knox on 22  June  2001.   He
had full active range of motion.  His straight leg raise was  negative,  but
there was some "tightness" with the right.  Muscle strength  was  normal  in
both legs.  His reflexes were normal, and he was non-tender to palpation.

In November 2001, at the time of his separation from service, the July  2001
VASRD was in effect.  Back in 2001, lumbar spine range of motion  impairment
was judged to be slight (10%), moderate (20%), or severe (40%),  based  upon
the rater’s opinion regarding degree of severity.  In this  case,  the  CI’s
back examination on 22 June 2001 did not show any thoraco-lumbar  limitation
of motion.  As noted above, the only  abnormality  found  on  the  MEB  back
examination was some “tightness” with straight leg raise on the  right.   On
10 July 2002, the CI had a general medical examination  at  the  VA  Medical
Center in Tomah, WI.  At that exam, he was able to bend forward  90  degrees
with no pain, but when he came back  up  to  the  upright  position  he  had
moderate pain in the lumbosacral area.  Also,  bending  20  degrees  to  the
left caused minor discomfort.  Straight leg  raise  was  negative,  reflexes
were  normal,  and  there  were  no  neurological  findings  in  the   lower
extremities.

The Board carefully examined all  of  the  available  evidence.   The  Board
evaluated the CI’s low back condition, with application of  the  2001  VASRD
coding and rating criteria, not the current coding and rating criteria.   As
noted above, the CI had no thoraco-lumbar limitation of motion  on  22  June
2001.  However, he did have characteristic pain on  motion.   Following  due
deliberation, and mindful  of  VASRD  §4.3  (reasonable  doubt),  the  Board
unanimously recommends a disability rating  of  10%  for  chronic  low  back
pain.  There was  no  documented  evidence  of  disabling  peripheral  nerve
involvement (radiculopathy).

Remaining Conditions.  Shoulder pain, scar on left thigh, and several  other
conditions were noted in the Disability Evaluation System (DES) file.   None
of these conditions were the basis for profiling and  none  were  implicated
in the commander’s statement.  These conditions were  all  reviewed  by  the
action officer and considered by the Board.  It  was  determined  that  none
could  be  argued  as  unfitting   and   subject   to   separation   rating.
Additionally,  other  conditions  were  noted  in  the  VA  rating  decision
proximal to separation, but were not documented in the DES file.  The  Board
does not have the authority to render fitness or rating recommendations  for
any conditions not considered by  the  DES.   The  Board  therefore  has  no
reasonable basis for recommending any additional  unfitting  conditions  for
separation rating.


BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military  Department
regulations or guidelines relied upon by the 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.  In the matter of the chronic low  back  pain,
the Board unanimously recommends a disability separation rating of 10%,  IAW
§4.71a of the 2001 VASRD.  In the matter of the shoulder pain, scar on  left
thigh, or  any  other  conditions  eligible  for  consideration,  the  Board
unanimously agrees that it  cannot  recommend  any  findings  of  unfit  for
additional rating at separation.


RECOMMENDATION:  The  Board  therefore  recommends  that  there  be  no  re-
characterization of the CI’s disability and separation determination.

|UNFITTING CONDITION                               |VASRD CODE  |RATING  |
|Chronic Low Back Pain                             |5299-5295   |10%     |
|COMBINED    |10%     |


The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20100112, w/atchs.
Exhibit B.  Service Treatment Record.
Exhibit C.  Department of Veterans' Affairs Treatment Record.





            XXXXXXXXX
            President
                                                                    Physical
Disability Board of Review







SFMR-RB
DEPARTMENT OF THE ARMY
ARMY REVIEW BOARDS AGENCY
1901 SOUTH BELL STREET 2ND FLOOR
ARLINGTON, VA 22202-4508

28 SEP 2011

MEMORANDUM FOR Commander, US Army Physical Disability Agency
(TAPD-ZB I WRAMC, Building 7, Washington, D.C. 20307-5001

SUBJECT: Department of Defense Physical Disability Board of Review
Recommendation
for AR20110018879 (PD201000080)

I have reviewed the enclosed Department of Defense Physical Disability
Board of
Review (000 PDBR) recommendation and record of proceedings pertaining to
the
subject individual. Under the authority of Title 10, United States Code,
section 1554a,
I accept the Board's recommendation and hereby deny the individual's
application.
This decision is final. The individual concerned, counsel (if any), and any
Members of
Congress who have shown interest in this application have been notified of
this decision
by mail.

BY ORDER OF THE SECRETARY OF THE ARMY:


Encl

CF:
( ) 000 PDBR
( ) OVA

Deputy Assistant Secretary
(Army Review Boards)