RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01624
BRANCH OF SERVICE:  Army  	SEPARATION DATE:  20020626

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Explosive Ordinance Disposal Specialist, medically separated for “chronic neck pain,” with a disability rating of 0%.   

CI CONTENTION:  “Review all conditions.”  His complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited 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.  Any conditions outside the Board’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 Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations 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 at the time of separation.  The Board 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 Board 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 - 20020530	VARD -20040421	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain	5099-5003	0%	Degenerative Arthritis Cervical Spine	5010-5290	10%	20040330	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Neck Pain. According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was first seen for neck pain in January 2001 after weightlifting.  He reported a history of neck tightness since a car accident in 1997.  The range of motion (ROM) and neurological examination were normal.  He was treated with ROM exercises, physical therapy and medications.  His pain persisted and an MRI was done on 12 October 2001.  It showed a small osteophyte (bone growth) at C6, but was otherwise normal.  Electro-diagnostic testing of the upper extremities on 26 February 2002 was normal.  Due to persistent symptoms which precluded the wear of protective equipment, the CI was referred for an MEB.  At the MEB examination (recorded on DD Forms 2807 and 2808) dated 2 April 2002, 3 months prior to separation, the CI reported ongoing neck pain.  On examination, he was found to have tightness of the neck muscles.  Strength was normal and atrophy absent.  The neurological examination was checked “normal.”  Rotation and extension were reduced.  

The MEB NARSUM examination was performed a week later.  The CI reported that his symptoms had improved with treatment, but not resolved.  The neurological examination was normal.  Tenderness of the neck muscles was present but spasm was absent.  The ROM was recorded as full flexion and extension, but with discomfort on full extension.  The remainder of the ROM values were also normal.  Incapacitation was not recorded.  The MRI was repeated on 26 April 2002 and was normal without evidence of significant degenerative disc or stenosis of the spine or foramina.  The MEB forwarded “chronic neck pain” for PEB adjudication.  During a 25 September 2002 primary care visit, 3 months after separation, the CI reported chronic neck pain.  The ROM was recorded to be “fairly good” although painful.  He was noted to ambulate “without much difficulty.”  The 30 March 2004 VA Compensation and Pension (C&P) evaluation was 21 months after separation.  The CI reported continued pain in the neck region but denied neurological symptoms.  On examination, the CI was in no distress, tenderness was present and the gait was normal.  Spasm was not documented and atrophy was absent.  The ROM was reduced in rotation and lateral bending, but flexion and extension were normal.  Strength and reflexes were normal.  X-rays showed no soft tissue pathology (without comment on the bony structures).  There was no clinical evidence of a radiculopathy.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 0%, coded 5099-5003 (analogous to degenerative arthritis) citing the US Army Physical Disability Agency pain policy.  The VA rated the neck condition, recorded as degenerative arthritis of the cervical spine, 10%, coded 5010-5290 (traumatic arthritis-limitation of motion of the cervical spine), using the STR and C&P examination 21 months after separation.  The Board noted that the ROM was typically full, but reduced slightly on some examinations.  Painful motion was consistently present though and supported a 10% rating as adjudicated by the VA.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the neck condition, coded 5290.  

BOARD FINDINGS:  In the matter of the neck condition, the Board unanimously recommends a disability rating of 10%, coded 5290 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Neck Pain	5290	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150624, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170006480, XXXXXXXXXXXXXXXXXX

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XXXXXXXXXXXXXXXXXX
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Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	 
Enclosure