RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01551
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060724

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty, Petroleum Supply Specialist, medically separated for “chronic neck pain” with a disability rating of 10%. 

CI CONTENTION:  In addition to his neck pain, review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) was requested.  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 - 20060418	VARD - 20070221	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain	5299-5237	10%	Cervical Strain	5237	10%	20070103	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Chronic Neck Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s neck condition began in July 2004 after jumping out of a tactical vehicle wearing full gear.  Electrodiagnostic studies revealed a C6 radiculopathy, but an MRI revealed no significant disc herniation at C5-C6.  However, there was a tiny annular protrusion at C4-5 without significant foraminal stenosis.  A CT showed some bulging disks, but no ruptures.  A repeat MRI showed a minimal bulge at C4-C5, but no other abnormality.  Although two neurosurgeons were consulted, neither recommended surgery.  

The 15 March 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, showed neck discomfort (pain) with flexion and extension, but measurements were not provided.  There were no radicular signs, spasm, or atrophy and there was good muscle strength.  The 15 March 2006 MEB NARSUM examination was conducted on the same date as the MEB examination by the same physician referred to the range of motion (ROM) evaluation below by physical therapy.  The 16 March 2006 physical therapy ROM evaluation showed 55 degrees of flexion (normal 45) and combined cervical ROM of 270 degrees (normal 340).  Pain was noted on end ROMs.  

At the 3 January 2007 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported neck pain and tenderness.  Physical examination showed a normal gait.  The ROM evaluation showed flexion of 35 degrees and combined ROM of 225 degrees.  There was no pain with repetition or change in ROM.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 10%, analogously coded as 5237 (lumbosacral strain), citing combined cervical ROM of 290 degrees.  The VA also rated the neck condition 10%, coded 5237, based on the C&P examination, citing no objective evidence of muscle spasms, forward flexion of 35 degrees, and combined ROM of 225 degrees.

The panel agreed that a 10% rating, but no higher, was justified for combined ROM (greater than 170 degrees but not greater than 335 degrees), as reported on the PT and VA examinations.  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 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.  

AR20180014705, 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.