RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01783
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20060307

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Metal Worker, medically separated for “chronic neck pain” with a disability rating of 10%.  

CI CONTENTION:  “Review all conditions.”  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 to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the Medical Evaluation Board, 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 - 20051130	VARD - 20070316	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain	5241	10%	Cervical Spine Degenerative Disc Disease	5238	10%	20051206	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Chronic Neck Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s neck condition began in 2003 during basic training without injury or trauma.  X-rays showed cervical spine degenerative disc disease.  An MRI performed in January 2005 revealed C5-6 and C6-7 level disc protrusions.  The CI underwent a C5-6 and C6-7 fusion in April 2005.  

The 31 October 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of chronic neck pain, but radicular symptoms down the right arm had resolved.  The neck pain was exacerbated by prolonged lying, sitting, or walking; or lifting and carrying objects weighing more than 10 pounds.  Physical examination showed a normal gait and stance.  Motor strength and reflexes were normal.  A neck (nerve root) compression test did not cause radiating pain to the arms.  Neck flexion was 50 degrees (45 normal) and combined range of motion (ROM) was 300 degrees (normal 340); mild stiffness was noted, but painful motion was not addressed.  It was noted that electrodiagnostic studies only found right ulnar sensory disturbance which was presumed secondary to cervical spine disease.  

At the 6 December 2005 VA Compensation and Pension (C&P) examination, 3 months before separation, the CI reported chronic neck pain after physical activity.  Her neck ROM had improved and radicular right small finger pain had decreased.  Physical examination showed normal posture and gait.  There was no joint swelling, redness, or deformity, but there was C5-7 tenderness.  Strength and sensory function testing was normal.  ROM was flexion to 40 degrees and combined ROM was 245; painful motion was absent.  There was no loss of motion with repetition.  

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 mild stiffness with ROM.  The VA also rated the neck condition 10%, coded 5238 (spinal stenosis), based on the C&P examination, citing limitation of flexion.  

The panel agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 40 degrees), as reported on the MEB NARSUM 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.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170301, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180008644, 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