RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01783
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20041213

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a National Guard E5, Military Policeman, medically separated for “chronic neck pain” with a disability rating of 10%.

CI CONTENTION:  The CI made no specific contention, but insinuated that his judgment was impaired at the time of his separation.  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 - 20041213	VARD - 20050520	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain	5241	10%	Residuals, Status Post Cervical Fusion	5243	20%	20050426	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Neck Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent cervical spine surgery with C3-7 fusion in March 2004 for degenerative disc disease with spinal stenosis.  Radiograph studies on 23 June 2004 showed “stable appearance of the [fusion] with no change in the position of the metal plate anterior to C4 through C7.”  Spondylosis changes was noted at C2, C3, and narrowing of the C2-3 disc space was also noted.

The 13 July 2004 MEB examination (recorded on the NARSUM and DD Forms 2807-1 and 2808), 5 months prior to separation, noted limitation of function of neck and intermittent pain.  Physical examination showed pain to palpation over the cervical spine and neck stiffness.  Range of motion (ROM) testing showed 30 degrees of flexion (normal 45) and total combined ROM of 195 degrees (normal 340).  However, the NARSUM recorded cervical flexion of 40 degrees and total combined ROM of 195 degrees with stiffness noted.

At the 26 April 2005 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported intermittent neck pain that was aggravated by looking up or looking to the side.  Physical examination showed no significant tenderness or spasm.  ROM testing showed 25 degrees of flexion and total combined ROM of 140 degrees.  There was pain on motion, but no additional limitation of motion with repetitive use.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 10%, coded 5241 (spinal fusion), citing combined cervical ROM of 205 degrees without neurologic abnormality.  The VA rated the neck condition 20% coded 5243 (intervertebral disc syndrome), based on the C&P examination 5 months after separation, citing forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees.  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 as reported on the MEB and VA examinations.  The panel was unable to find additional ROM recordings in the STR that would justify the lower rating of 10% adjudicated by the PEB.  There was no documentation of intervertebral disc syndrome (IVDS) 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 recommends a disability rating of 20% for the neck condition, coded 5241.  

BOARD FINDINGS:  In the matter of the neck condition, the panel unanimously recommends a disability rating of 20%, coded 5241 IAW VASRD §4.71a.  There are 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	5241	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20161123, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180000025, 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