RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01884
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20061206

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

CI CONTENTION:  The CI contends for his unfitting chronic neck condition and for greater benefits. 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 - 20060824	VARD - 20150508	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain	5243	0%	Cervical Degenerative Arthritis, Intervertebral Disc Syndrome	5242-5243	10%	20150429	
			Radiculopathy, Left Upper Extremity Associated with Cervical Degenerative Arthritis,  Intervertebral Disc Syndrome	8514	20%	20150429	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Chronic Neck Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s neck pain condition began in March 2005 while deployed to Afghanistan.  The CI denied any specific injury or trauma.  The CI was initially treated in theater, but was eventually medically evacuated for further evaluation and treatment in Germany.  

According to the commander’s statement, the CI had a CT scan (May 2005) at Camp Casey Afghanistan and an MRI (November 2005) in Landstuhl, Germany which revealed degenerative disc disease and disc herniation at C5-6 and C6-7.  There were no electrodiagnostic studies in the STR.  Evaluation by neurosurgery stated that CI had “relatively mild symptoms and was not a surgical candidate.”  He was advised to refrain from surgery due to his young and the potential problems in the future due to proceeding with the surgery at that time.  There was no surgical indication, extensive physical therapy, epidural steroid injections and medications, the cervical spine condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for MEB.  The MEB forwarded “neck pain with radiculopathy on the left upper extremity due to HNP C5/C6, left foraminal narrowing and stenosis at C5/C6,” and “difficulty breathing” for PEB adjudication.  

The MEB NARSUM examination on 13 July 2006 (5 months prior to separation) showed the CI ambulating and sitting with a stiff neck.  Rotational motion of the head and neck exhibited rotation at the shoulders secondary to pain which radiated down the left shoulder and arm to the hand.  Compressional tests with the head and neck rotated produced radicular pain down the left arm to the hands.  There was moderately severe limitation of the range of motion of the cervical spine in all directions.  There was full ROM in the upper extremity.  Motor strength was equal bilaterally, as were reflexes.  There was no atrophy of the upper extremities.  At a physical therapy evaluation performed on 19 July 2006, goniometric measurements of the ROM of the cervical spine was documented as flexion at 20 degrees, extension at 30 degrees, left lateral flexion at 10 degrees, right lateral flexion at 40 degrees, left rotation at 40 degrees and right rotation at 50 degrees; combined 190 degrees..  All end extremes of ROM were limited by pain.  There was no VA Compensation and Pension (C&P) evaluation proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic neck pain condition 0% under the 5243 code (intervertebral disc syndrome).  There was no VA rating decision assigned to the neck condition within the probative period due to no C&P evaluation proximate to separation.  The panel agreed that a 20% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 60 degrees.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the chronic neck pain condition, coded 5243. 

BOARD FINDINGS:  In the matter of the chronic neck pain condition, the panel unanimously recommends a disability rating of 20%, coded 5243 IAW VASRD §4.71a.  There were no other conditions within the panel’s scope of review for consideration.  

The panel 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	5243	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150704, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170009239, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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