RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXX		CASE: PD-2015-02308 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20040421

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E3, Motor Transport Operator, medically separated for “chronic pain, neck and left arm” with a disability rating of 0%.

CI CONTENTION:   The CI contends his disability continues to negatively affect his life.	The 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 - 20030926		VARD - 20040513	
Condition	Code	Rating		Condition	Code	Rating	Exam	
Chronic Pain, Neck & L Arm…	5099-5003	0%		Pinched Neck Nerves w/ L Arm…	5243	NSC	NA	
COMBINED RATING: 0%		COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Chronic Pain, Neck and Left Arm. According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s underwent neck surgery (C6-C7 left sided posterolateral foraminotomy) in September 2000 to relieve left arm pain and weakness. At the orthopedic examination on 9 April 2003, 12 months prior to separation, recorded complaints of radiation of pain down to the left forearm. Physical examination showed normal strength, decreased to absent reflexes of the left upper extremity, and hyperesthesia (increased sensitivity from nerve irritation) of the middle 3 fingers. Neck range of motion (ROM) was recorded as flexion as “chin to chest” (normal 45), with combined ROM of 270 degrees (normal 340). Painful motion was not addressed. Radiographic evaluation (X-rays) documented degenerative joint disease with normal interspacing of the vertebral bones.

At the 24 April 2003 MEB NARSUM examination, the CI reported pain radiating to the left index finger, and occasionally in the mid forearm. He also reported inability to perform push-ups, sit- ups, run, or wear headgear or a rucksack. The examiner referenced the April 2003 orthopedic examination. The May 2003 Commander’s statement implicated the “neck and shoulder injury” prevented the CI from operating and performing operators’ level maintenance on assigned vehicles. At the July 2003 MEB examination (recorded on DD Forms 2807 and 2808), 9 months prior to separation, the CI reported neck and arm pain radiating to the fingers with difficulty turning the head to the left. The physical examination showed “decreased” ROM of the cervical spine. There was no documentation of electrodiagnostic studies for evaluation of radiculopathy. There was no VA Compensation and Pension (C&P) evaluation in evidence for review.

The panel directed attention to the rating recommendation based on the above evidence. The PEB rated 0% for the chronic neck and arm condition, analogously coded 5099-5003 (degenerative arthritis), citing the US Army Physical Disability Agency (USAPDA) pain policy. The VA determined the condition was not service connected (NSC), citing a lack of evidence of a chronic disability. Although there was no documentation of painful motion, the panel agreed that a 10% rating, but no higher, was justified for the limitation of combined ROM (greater than 170 degrees but not greater than 335 degrees) as reported on the April 2003 orthopedic examination, IAW VASRD §4.71a. There was no evidence of intervertebral disc syndrome (IVDS) which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of a higher rating under the alternate VASRD formula (for IVDS). After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the neck condition, coded 5237 (cervical strain). After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the chronic neck pain condition, coded 5237 (cervical strain).

BOARD FINDINGS: In the matter of the chronic neck pain condition, the panel unanimously recommends a disability rating of 10%, 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 Pain, Neck and Left Arm Pain	5243	10%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20150702, w/atchs Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record

AR20170012229, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXX:

	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,