RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01482
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070213

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E6, Cable Systems Installer/Maintainer, medically separated for “chronic neck and left shoulder pain due to cervical spondylosis” with a disability rating of 10%.  

CI CONTENTION:  His neck condition continues to worsen and he requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20070105	VARD - 20080609	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck and Left Shoulder Pain due to Cervical Spondylosis	5299-5237	10%	Chronic Neck with Left Shoulder Pain due to Cervical Spondylosis… 	5242	20%	20070625	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Chronic Neck and Left Shoulder Pain due to Cervical Spondylosis.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s neck pain condition insidiously began in August 2005 while deployed.  An MRI revealed multi-level cervical spine degenerative disc disease.  

During the 13 June 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 8 months prior to separation, the CI reported left shoulder and headache symptoms related to a primary neck pain condition.  Physical examination revealed cervical spinal tenderness and spasms.  Range of motion (ROM) was flexion to 45 degrees (normal) and combined ROM was 230 degrees (normal 340); painful motion was present.  At the 31 July 2006 MEB NARSUM examination, 7 months prior to separation, the CI’s chief complaint was neck pain and left shoulder pain.  Physical examination referenced the aforementioned cervical spine ROM and painful motion.  Spinal tenderness and muscle spasm were present.  

At the 25 June 2007 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported constant pain on his left side between the neck and the shoulder.  Physical examination revealed cervical tenderness without muscle spasms.  Upper extremity strength was 5/5 and reflexes were intact.  ROM was flexion to 25 degrees and combined ROM was 150 degrees; painful motion was present.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck pain condition 10%, analogously coded 5299-5237 (cervical strain), citing painful motion and tenderness.  The VA rated the neck pain condition 20%, coded 5242 (degenerative arthritis of the spine), based on the C&P examination, citing limitation of forward or combined ROM.  

The panel agreed that a 20% rating, but no higher, was supported for limitation of cervical flexion to 25 degrees as reported on the VA examination most proximate to separation.  There was no evidence of intervertebral disc syndrome which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under the alternate VASRD formula for that condition.  The panel noted the PEB explicitly adjudicated left shoulder neck pain due to cervical spondylosis without neurological or electrodiagnostic abnormality and the CI contended a radiculopathy condition.   Although the CI reported radiating neck pain into his left shoulder, this pain is subsumed under the general spine rating criteria, which specifically states “with or without symptoms such as pain (whether or not it radiates).”  There was no objective evidence of a radiculopathy with functional impairment (such as weakness) nor performance-based evidence from the record that this condition significantly interfered with satisfactory duty performance at separation.  Therefore, the panel concluded that an additional disability rating was not justified on this basis.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the chronic neck condition, coded 5242.

BOARD FINDINGS:  In the matter of the neck pain condition, the panel recommends a disability rating of 20%, coded 5242 IAW VASRD §4.71.a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Neck and Left Shoulder Pain due to Cervical Spondylosis	5242	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170720, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180007887, XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

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