RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00091
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Multichannel Transmission Systems Operator medically separated for “neck pain” with a disability rating of 10%.

CI CONTENTION:  “SSDI was awarded for the condition.”  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 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 panel’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 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 - 20040426	VARD - 20050107	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Cervical Degenerative Disease without Neurologic Abnormality	5299-5237	10%	Cervical Spine Degenerative Disc Disease	5243	10%	20040716	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Cervical Degenerative Disease…Diagnosis.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s neck condition began in 1995.  The onset of the neck condition was insidious in nature and worsened with the wearing of body armor.  Magnetic Resonance Imagining (MRI) on 18 December 2002 revealed evidence of degenerative disc disease at C4-C5, C5-C6, and C6-C7.  No evidence of nerve involvement or evidence of herniated disc was present.  

The MEB NARSUM examination on 23 March 2004, 5 months prior to separation, noted complaints of neck pain preventing the CI from wearing his body armor or Kevlar.  Physical examination was unremarkable with the exception of pain with axial compression of the neck.  The examiner deferred to the March 2004 PT examination for range of motion (ROM) measurements.  The ROM recorded cervical flexion of 40 degrees (normal=45 degrees) with combined ROM of 185 degrees (normal 340).   

At the 16 July 2004 VA Compensation and Pension (C&P) evaluation, performed 1 months before separation, the CI reported dull aches in the posterior neck area.  He also reported pain occasionally radiating from the neck into both trapezius areas, both shoulders, and down both arms.  Discomfort was aggravated by maintaining a position for a prolonged period of time and rotating his head.  Physical exam showed no loss of normal curvature of the lower back.  No evidence of neurological compromise.  Good strength and muscle tone present.  ROM documented cervical flexion to 45 degrees, with combined ROM of 245 degrees.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the neck condition 10%, coded 5299-5237 (analogous to cervical strain), citing combined range of motion 185 degrees.  The VA also rated the neck condition 10% coded 5243 (intervertebral disc syndrome), based on the VA C&P examination 1 month before separation, citing slight limitation of motion. 

The panel agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 40 degrees) and/or combined ROM (greater than 170 degrees but not greater than 335 degrees) reported on the Physical Therapy and VA examinations proximate to separation.  There was no muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, thus the next higher 20% rating was not justified on this basis.  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 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 neck condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There are 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 20160222, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170013295, 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