RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00002
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081102

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Light Wheel Vehicle Mechanic, medically separated for “cervical degenerative disc disease [DDD]” with a disability rating of 20%.

CI CONTENTION:  The CI made no specific contention.  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 - 20080718	VARD - 20150221	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Cervical DDD	5299-5242	20%	DDD Cervical Spine	5237	20%	20150116	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Cervical DDD.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s neck condition began in approximately 1989, prior to service, after playing drums in a marching band.  The cervical spine was further aggravated in service while wearing field gear during exercises, but the CI denied any specific injury or trauma to the neck.  Radiographic studies showed DDD at C3-C6 with bulging at C4-C5 and C5-C6 and narrowing of the neuroforamina (space through which the spinal nerve root passes) at C5-C6.  

During the 29 January 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 9 months prior to separation, the CI reported constant neck pain with shooting pain down the left arm and spine.  He also reported neck stiffness and muscles spasms.  His condition was aggravated by quick rotational movements, mechanic tasks, running, and wearing personal protective equipment.   Physical examination showed no paracervical muscle tenderness, but there was left trapezius muscle tenderness to palpation.  Range of motion (ROM) was limited by pain and the examiner noted decreased left rotation, but no measurements were listed.  Bilateral upper extremity motor strength was normal. 

At the 21 February 2008 primary care clinic appointment, 8 months before separation, the CI reported chronic neck pain that extended from the midline to the bilateral shoulders and trapezius muscles.  On examination the CI walked with a normal gait and displayed no focal deficits.  

At the 7 March 2008 physical therapy ROM study for the MEB on 7 March 2008, 7 months before separation, there was flexion of 20 degrees (normal 45) and combined ROM of 250 degrees (normal 340)  with pain on motion.  There was no tenderness, muscle spasm or guarding.  The CI walked with a normal gait and showed no abnormal spinal contour.  

The 10 April 2008 MEB NARSUM examination, 6 months prior to separation, noted complaints of constant 4/20 neck pain.  The examiner noted that the CI was able to do his duty with infrequent profiles, but could not wear battle gear nor perform any movement while wearing the equipment.  A focused physical examination showed tenderness to palpation at the bilateral cervical paraspinal muscles and upper trapezius, without tenderness to palpation over the spinous processes.  The upper extremity neurologic examination showed normal motor strength, sensation and reflexes.   Provocative measures to determine nerve root irritation were negative. 
There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 20%, coded 5299-5242 (analogous to degenerative arthritis of the spine), citing limitation of forward flexion.  The VA also rated the neck condition 20% based on an examination 6 years after separation.  The panel agreed that a 20% rating, but no higher, was justified for limitation of flexion greater than 15 degrees but not greater than 30 degrees, reported on the MEB physical therapy ROM examination.  There was no documentation of intervertebral disc syndrome with incapacitating episodes which would provide for a higher rating under that formula.  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 adjudication for the neck condition.  

BOARD FINDINGS:  In the matter of the cervical DDD condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no nor modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20151217, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170013179, XXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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