RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00802
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20060530

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

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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20060508	VARD - 20070320	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain	5241	10%	Status Post Anterior Cervical Disc Fusion 	5243	10%	20060901	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Chronic Neck Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent discectomy and fusion of the C6-7 vertebrae in May 2005.  Post-surgical X-ray studies showed a small bone-like density in the nuchal ligament at the C6 level with no other abnormal findings.  

During the 27 March 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the CI reported neck pain.  Physical examination showed tenderness.  Cervical spine range of motion (ROM) measurements showed full flexion (45 degrees) and combined ROM of 215 degrees (normal 340) after repetition, with painful motion noted.  The 7 April 2006 MEB NARSUM, 2 months prior to separation, noted complaints of a chronic dull achy pain at the posterior aspect of the base of the cervical spine, aggravated by jumping or jarring motions, running, sit-ups, wearing a rucksack or body armor, overhead lifting and other activities.  The examiner referred to the results of the MEB examination mentioned above, which was silent regarding muscle spasm, guarding, gait and spinal contour.  At the 8 August 2006 VA primary care appointment, 2 months after separation, the CI reported constant aching in his neck.  Cervical ROM was moderately limited in flexion, extension and lateral flexion and he had good rotation, though no measurements were provided.    

At the 1 September 2006 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the CI reported constant aching, deep dull pain.  The pain flared when he turned suddenly, sneezed or lifted with his upper body.  He denied missed work due to his neck pain.  Physical examination showed a normal gait and spinal contour with no objective evidence of spasm, weakness or tenderness.  ROM measurements were flexion of 45 degrees and combined ROM of 230 degrees, limited by pain.  

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 tenderness and painful limitation of motion.  The VA also rated the neck condition 10%, coded 5243 (intervertebral disc syndrome), based on the C&P examination 3 months after separation, citing limited ROM.  

The panel agreed that a 10% rating, but no higher, was justified for limitation of combined ROM greater than 170 degrees but not greater than 335 degrees, as reported on the MEB 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.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded 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 panel’s scope of review for consideration.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination. 

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170220, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180004910, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

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