Search Decisions

Decision Text

AF | PDBR | CY2013 | PD-2013-01686
Original file (PD-2013-01686.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXX       CASE: PD-2013-01686
BRANCH OF SERVICE: AIR FORCE     BOARD DATE: 20141121
SEPARATION DATE: 20041209


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty AMN/E-2 (Basic Trainee) medically separated for back pain. The back condition did not improve adequately to meet the physical requirements for completion of training. She was referred for a Medical Evaluation Board (MEB). The back condition, characterized as “T12 wedge compression fracture,” was forwarded to the Physical Evaluation Board (PEB) IAW AFI 48-123. No other conditions were submitted by the MEB. The Informal PEB adjudicated the back pain condition as unfitting, rated at 10%. The CI made no appeals and was medically separated.


CI CONTENTION: The CI presented a lengthy contention, citing technical and diagnostic information, including range of motion evidence as well as imaging information about her back condition, which the board reviewed.


SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e.(2). It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI. The rating for the unfitting back condition is addressed below. No other conditions are within the defined purview of the Board. Any conditions outside the Board’s scope of review may be eligible for consideration by the Board for Correction of Military Records.

The Board acknowledges the sentiment expressed by the CI regarding the impairment with which her back condition continues to burden her, and the significant impact it has had on her quality of life. It is noted for the record that the Board is subject to the same laws for disability entitlements as those under which the Disability Evaluation System (DES) operates. The DES has neither the role nor the authority to compensate members for future severity or potential complications of conditions. That role and authority is granted to the Department of Veterans Affairs (DVA). The Board evaluates DVA evidence in arriving at its recommendations, but its authority resides in evaluating the fairness of DES fitness and rating determinations at the time of separation. The DVA however, is empowered to compensate for all service connected conditions and to periodically re-evaluate conditions for the purpose of adjusting the Veteran’s disability rating should the degree of impairment change over time.


 RATING COMPARISON :

Service IPEB – Dated 20040107
 VA – (16 weeks Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Chronic Back Pain 5237 10% Chronic Back Pain 5235 20% 20040429
Other x 0 (In Scope)
 Other x 2
Combined: 10%
 Combined: 20%
Derived from VA Rating Decision (VA RD ) dated 20040610 (most proximate to date of separation )


ANALYSIS SUMMARY:

Chronic Back Pain. On 27 June 2003, CI fell ten feet and landed on her buttocks, subsequently was found to have a T-12 spinal compression fracture that was treated with pain medication and a back brace. Due to the long term prognosis of her condition, MEB was initiated. The MEB narrative summary on 3 October 2003, the examiner noted tenderness of the lower back, but commented that the CI’s condition was stable with no focal neurologic deficits. Thoracolumbar range-of-motion (ROM) was omitted during this visit. In November 2003,
(7 weeks prior to separation), during her follow-up orthopedic appointment, the CI reported that she “was out of her brace with most activities.” Physical examination of the back revealed no tenderness to palpation or percussion, ROM was described as full, active and without pain, with only mild lumbosacral junction discomfort. There was no pain at the site of previous fracture.

During her VA Compensation and Pension examination in April 2004 (4 months after separation), the examiner noted mild thoracolumbar spasm from T-8 to L-2 and midline tenderness from T-11 to L-1. Straight leg raise was negative. Neurological exam showed no dermatomal sensory loss. ROM testing revealed thoracolumbar flexion of 40 degrees and combined thoracolumbar ROM of 150 degrees.

The Board carefully reviewed the data from the back examinations noted above, and directed attention to its rating recommendation. The November 2003 exam was closest to the date of surgery and therefore carries significant probative value. At that exam, there was full, active ROM with only mild lumbosacral junction discomfort, without complaint of pain at the site of previous fracture. The Board determined that the back pain condition was essentially non-compensable based on the Veterans Affairs Schedule for Rating Disabilities (VASRD) §4.71a General Rating Formula for Diseases and Injuries of the Spine. However; IAW VASRD §4.40, when part of the musculoskeletal system becomes painful on use, it must be regarded as seriously disabled. A 10% rating is warranted when there is satisfactory evidence of functional limitation due to pain. There was no path to a higher rating since there was no evidence of a significantly disabling back condition that would justify a higher rating.

The Board also considered the matter of peripheral neuropathy. After reviewing all the information in the record, there was insufficient evidence of a clinically significant neuropathy that interfered with performance of military duties. Therefore, the Board concluded that there was no unfitting radiculopathy present at the time of separation. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board found insufficient cause to recommend a change in the PEB adjudication for the back pain condition.


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. The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised. In the matter of the chronic back pain and IAW VASRD §4.40, the Board unanimously recommends no change in the PEB adjudication. There were no other conditions within the Board’s scope of review for consideration.


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


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20131002, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record





                                   
XXXXXXXXXXXX
President
Physical Disability Board of Review





 SAF/MRB
Dear XXXXXXXXXXXX:

 Reference your application submitted under the provisions of DoDI 6040.44 (Title 10 U.S.C. § 1554a), PDBR Case Number PD-2013-01686.
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 re-characterization or modification 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 re-characterization of your separation is not warranted. Accordingly, I accept their recommendation that your application be denied.

                                                                Sincerely,
XXXXXXXXXXXX
Director
Air Force Review Boards Agency
Attachment:
Record of Proceedings

Similar Decisions

  • AF | PDBR | CY2013 | PD-2013-02298

    Original file (PD-2013-02298.rtf) Auto-classification: Denied

    Any conditions or contention not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Board for Correction of Military Records (BCMR).The Board acknowledges the opinion of the CI’s treating physician in his letter to the FPEB that service mal-treatment contributed to the disability. The Board agreed that no rating could be recommended under this code. I have carefully reviewed the evidence of record and the...

  • AF | PDBR | CY2012 | PD 2012 00982

    Original file (PD 2012 00982.txt) Auto-classification: Denied

    The 2003 Veterans Affairs Schedule for Rating Disabilities (VASRD) coding and rating standards for the spine, which were in effect at the time of separation, were changed to the current §4.71a rating standards in 2004, and were identical to the 2003 VASRD standards used by the VA in its initial rating decision. IAW DoDI 6040.44, this Board must consider the appropriate rating for the CI’s back condition at separation based on the VASRD standards in effect at the time of separation. The...

  • AF | PDBR | CY2011 | PD2011-01028

    Original file (PD2011-01028.docx) Auto-classification: Approved

    The Board evaluates VA evidence proximal to separation in arriving at its recommendations, but its authority resides in evaluating the fairness of DES fitness decisions and rating determinations for disability at the time of separation. The low back pain also radiated to the left buttock, hip and the upper anterior left thigh including “left sacroiliac joint pain, which is thought to be related to the low back pain.” X-rays of the lumbar spine and sacroiliac joints were normal; MRI of the...

  • AF | PDBR | CY2012 | PD2012 00950

    Original file (PD2012 00950.rtf) Auto-classification: Denied

    The hip condition, characterized as right inferior pubic ramus stress fracture,was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.No other conditions were submitted by the MEB.The PEBadjudicated chronic right groin and hip pain secondary to stress fracture of the inferior pubic ramus as unfitting, rated 0%with likely application of the US Army Physical Disability Agency (USAPDA) pain policy and theVeterans Affairs Schedule for Rating Disabilities (VASRD).The CI made no...

  • AF | PDBR | CY2013 | PD 2013 00055

    Original file (PD 2013 00055.rtf) Auto-classification: Denied

    The chronic low back condition, characterized as “chronic low back pain, EPTS with service aggravation” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.The MEB forwarded no other conditions to the PEB.The Informal PEB adjudicated “chronic low back pain” as unfitting and rated it at 10%. The PEB rated the unfitting chronic LBP10% (coded 5242, degenerative arthritis of the spine) with application of the VASRD general rating formula for diseases and injuries of the spine. ...

  • AF | PDBR | CY2013 | PD-2013-02125

    Original file (PD-2013-02125.rtf) Auto-classification: Approved

    He was referred to orthopedics for consultation.On 19January2005, while still deployed in Kuwait, he fell off the back of a truck and was unable to stand, complaining of left sided weakness and decreased sensation. The PEB rated at 0% and the VA rated at 10%. Physical Disability Board of Review

  • AF | PDBR | CY2012 | PD2012-00297

    Original file (PD2012-00297.pdf) Auto-classification: Denied

    RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW BRANCH OF SERVICE: ARMY SEPARATION DATE: 20060126 NAME: XXXXXXXXXXXXXXXX CASE NUMBER: PD1200297 BOARD DATE: 20121102 SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was a 1LT/O-2 (00E, Student Officer) medically separated for chronic low back pain (LBP). The CI accepted the PEB findings, and was medically separated with a 10% disability rating. 2...

  • AF | PDBR | CY2011 | PD2011-01045

    Original file (PD2011-01045.docx) Auto-classification: Approved

    The Board’s authority as defined in DoDI 6044.40, however, resides in evaluating the fairness of DES fitness determinations and rating decisions for disability at the time of separation. Neurosurgical notes do not indicate whether the scoliosis noted on x-rays was developmental in nature, due to the L1 vertebral fracture, or due to muscle spasm. Based on this ROM examination, the VA granted an additional 10% rating for back pain in accordance with the VASRD general rating formula for...

  • AF | PDBR | CY2013 | PD-2013-02590

    Original file (PD-2013-02590.rtf) Auto-classification: Denied

    Mid-Back Pain Condition . There was no increase in kyphosis at T12.The diagnosis rendered was T12 compression fracture with recalcitrant activity associated back pain.At the VA Compensation and Pension (C&P) examination on25 October 2007, 4 months after separation, the CI reported slight sensory impairment at the site of the fracture at the thoracolumbar junction and in the lower sacral area extending to the gluteal fold along the left side of the buttock. The Board determined that there...

  • AF | PDBR | CY2014 | PD-2014-02120

    Original file (PD-2014-02120.rtf) Auto-classification: Denied

    “Lumbago”was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.AnInformal PEB (IPEB) adjudicated chronic low back pain(LBP) without neurologic abnormality as unfitting, rated 0%. The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of theVeterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. RECOMMENDATION : The...