RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01017
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050730

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Motor Transport Operator, medically separated for “chronic neck pain secondary to degenerative disc disease (DDD) C5 through C7, status post diskectomy and fusion” with a disability rating of 20%.  

CI CONTENTION:  No specific contention made.  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 - 20050509	VARD – 20060130 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain	5241	20%	Cervical Degenerative Disc Disease S/P Fusion	5242	20%	20050927 	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:  

Chronic Neck Pain.   According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s chronic neck pain condition began in December 2003.  He was seen in the emergency room for right shoulder pain for one month.  An MRI of the cervical spine in January 2004 found normal alignment, with no evidence of fracture, subluxation or dislocation.  There was a left disk protrusion at the C5 to C6 level which contacted the C6 nerve root.  Right paracentral disk protrusion at the C6-C7 level caused moderate neuroforaminal stenosis.  There was moderate central canal stenosis at this level and disk protrusion may have contacted the right C7 nerve root.  Electrodiagnostic studies performed on 15 March 2004 were abnormal with evidence of a right C7 radiculopathy.  The CI underwent a C5-C6 and C6-C7 cervical discectomy and fusion in June 2004 for degenerative disc disease.  Postoperative physical therapy improved his cervical range of motion (ROM) but neck pain persisted.  

The 16 February 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of intermittent episodes of cervical pain, however, right upper extremity radicular symptoms had resolved.  The CI reported baseline pain from 1-3/10 daily.  Pain was exacerbated by wearing his Kevlar helmet, rucksack and equipment.  Physical examination showed a normal gait and contour.  The cervical spine ROM measurements showed flexion of 20 degrees (normal 45) and combined ROM of 215 degrees (normal 340) after repetition.  Upper extremity strength and reflexes were normal.  Exam maneuvers to provoke radicular symptoms were negative.  During the 21 March 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, physical examination showed decreased cervical ROM, and pain with all planes of movement.  

At the 27 September 2005 VA Compensation and Pension (C&P) evaluation, 2 months after separation, the CI denied radicular pain.  He reported pain in the mid C spine with minimal right thumb and index finger tingling almost constantly; however, he denied incapacitating episodes or flare-ups.  He used over-the-counter anti-inflammatory medication and a transcutaneous electrical nerve stimulation unit periodically for symptoms.  Physical examination noted the CI was left-hand dominant.  Posture and gait were normal.  There was no cervical muscle spasm or tenderness.  The cervical spine ROM measurements showed flexion of 25 degrees (normal 45) and combined ROM of 255 degrees (normal 340) after repetition.  The examiner stated there was “no pain with these motions today.”  There was no additional loss of motion with repetitive motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 20%, coded 5241 (spinal fusion), citing loss of flexion (and pain) to 20 degrees.  The VA also rated the cervical condition 20%, coded 5242 (degenerative arthritis of the spine), based on the C&P examination 2 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 NARSUM and VA examinations.  After surgery, 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 chronic neck pain condition and IAW VASRD §4.71a, the panel unanimously 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 20170223, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180005501, 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