RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02186
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040415

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Air National Guard or National Guard E5, Armor Crewman, medically separated for “chronic neck pain, without significant neurologic or electrodiagnostic abnormality,” with a disability rating of 20%.  

CI CONTENTION:  “Review all conditions.”  The 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 - 20040121	VARD - 20041015	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain	5237	20%	Neck Condition	5237	NSC	STR	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

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 February 2002 after a whiplash injury.  Electrodiagnostic studies on 9 July 2002, were negative for radiculopathy.  At a September 2002 neurosurgery clinic visit, 19 months pre-separation, the CI reported pain while driving, poor sleep and ineffective physical therapy with continued pain in the left shoulder area.  On physical examination, there was painful motion, normal motor and sensory function, and no evidence of spasms.  The CI underwent two epidural steroid injections (August and October 2002) without permanent relief.  Despite treatment, 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” for PEB adjudication.  

At the 7 August 2003 MEB examination (documented on DD Form 2808), 8 months pre-separation, the physical examination showed marked neck stiffness, tenderness of the posterior cervical spine, and no lateral rotation.  At a 27 October 2003 family practice clinic visit, 6 months pre-separation, the CI reported severe neck pain that radiated down the left arm and constant hand paresthesias.  The physical examination showed pain with light touch of the skin around the neck and neck pain with axial loading (Spurling test/ cervical compression).  The cervical range of motion (ROM) showed forward flexion to 20 degrees (normal 45), extension to 15 degrees (normal 45), bilateral lateral flexion to 15 degrees each (normal 45) and bilateral rotation to 10 degrees each (normal 80).  Total combined ROM was 85 degrees (normal 340).  

There was no VA Compensation and Pension (C&P) examination in evidence for review.  

The Board directed attention to the rating recommendation based on the above evidence.  The PEB rated the chronic neck pain condition 20% using the 5237 code (cervical spine strain), citing combined cervical ROM limited to 85 degrees.  After review of the STR, the VA did not grant service connection for the neck condition, citing no evidence of permanent or chronic disability.   

The Board considered the evidence for rating.  Members agreed that a 20% rating, but no higher, was justified for limitation of flexion (greater than 15 degrees but not greater than 30 degrees) and a combined ROM (not greater than 170 degrees) as reported on the NARSUM addendum examinations.  There was no documentation of intervertebral disc syndrome with incapacitating episodes which would provide for a higher rating under that formula, or evidence of ratable peripheral nerve impairment which would provide for additional rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the chronic neck pain condition.  

BOARD FINDINGS:  In the matter of the chronic neck pain condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  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 20150803, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170004213, XXXXXXXXXXXXXXXXXX 

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Dear XXXXXXXXXXXXXXXXXX:

	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