RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01574
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070905

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Reserve E5, Light Wheeled Vehicle Mechanic, medically separated for “chronic neck pain” and with a disability rating of 10%.  

CI CONTENTION:  The CI did not submit a specific contention in the application.  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting or non-compensable.  Any conditions outside the panel’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military Records.  Furthermore, the panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition(s) at the time of separation.  The panel has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The panel gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.

RATING COMPARISON:  

SERVICE PEB - 20070606	VARD - 20131126	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain…	5237	10%	Degenerative Disc Disease Cervical Spine With Anterolisthesis C7, and Radiculopathy Right Upper
Extremity	5243	10%	20130917	
			Radiculopathy Right Upper Extremity Associated With Degenerative Disc Disease Cervical Spine With
Anterolisthesis C7, and Radiculopathy Right Upper Extremity	8511	20%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY: 

Chronic Neck Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s neck pain condition began in July 2005 after falling from the cab of a 5 ton truck.  Initial X-ray review indicated “no acute changes.”  Repeat X-rays performed 6 months later in January 2007 revealed degenerative changes about the lower cervical (neck) spine as well as loss of cervical lordosis.  

The 25 January 2007 MEB NARSUM examination, 7 months prior to separation, the CI’s chief complaint was “neck pain.”  He also endorsed the inability to wear Kevlar for a prolonged period of time due to the worsening of neck pain.  His physical examination (PE) revealed painful and decreased neck range of motion (ROM) of right and left lateral flexion at 30 degrees (normal 45 each), right and left rotation of 45 degrees (normal 80 each), and normal flexion and extension for a combined cervical ROM of 240 degrees (normal 340).  Tenderness was present throughout the mid and lower cervical spine.  Neurosensory and strength appeared normal in both upper extremities.  

The VA Compensation and Pension (C&P) examination was performed nearly 6 years remote from separation.  Therefore, the panel’s final impairment recommendation will be based upon the STR and MEB-driven documents.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck pain condition at 10% under VASRD code 5237 (cervical spine strain), citing tenderness.  Based upon the remote C&P examination, the VA assigned a 10% rating under 5243 (intervertebral disc syndrome), citing forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees and a combined ROM greater than 170 degrees but not greater than 335 degrees.  In addition, the VA also provided a 20% rating for an associated radiculopathy using the 8511 code (paralysis of middle radicular group) for mild incomplete paralysis of a major extremity.  

The panel agreed that a 10% rating, but no higher, was justified for a combined ROM of the cervical spine greater than 170 degrees but not greater than 335 degrees as depicted on the probative NARSUM examination.  Although the CI’s X-rays indicated a “loss of cervical lordosis” (indicative of an abnormal spinal contour or a reversing lordosis), there was no evidence of such finding being caused by either the evidence of muscular spasms and or severe guarding and therefore the higher 20% rating was not supported.  There was no evidence of intervertebral disc syndrome (IVDS) which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under the alternate VASRD formula (for IVDS).  The Board also considered if additional disability rating was justified for peripheral nerve impairment due to radiculopathy.  There was no objective evidence of an upper extremity radiculopathy or neuropathy with functional impairment (such as weakness) that directly impacted fitness for duty.  The panel therefore concluded that an additional disability rating was not justified on this basis.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB’s adjudication for the neck pain condition.  

BOARD FINDINGS:  In the matter of the neck pain condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

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

AR20170008537, XXXXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

	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,					       
						      					
Enclosure