RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02029
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060818

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Unit Supply Specialist, medically separated for “chronic neck pain…” with a disability rating of 10%.   

CI CONTENTION:  “Chronic pain more severe than originally diagnosed.”  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 - 20060620	VARD - 20070926	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain, S/P C6-7 Discectomy and Fusion	5241	10%	Intervertebral Disc Syndrome (IVDS) with Degenerative Arthritis Changes	5243	10%	20070216	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:  

Chronic Neck pain, Status Post (S/P) C6-7 Discectomy and Fusion.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s chronic neck pain began in 2002 when he sustained an injury during an auto accident and was diagnosed with severe whiplash.  In April 2005, he reinjured his neck while engaged in hand-to-hand combat training.  Treatment was conservative as the injury was thought to be a severe sprain.  The pain continued and in July 2005 the CI had a sudden onset of severe pain in his neck with an MRI showing a herniated C6-7 disc.  In December 2005, the CI underwent a C6-7 cervical anterior discectomy and fusion.  Electrodiagnostic (EMG/NCV) testing in April 2006 was normal.  

The 6 April 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of chronic mid-cervical spine pain worse on the right side and intermittent radiating pain from the cervical spine down the right arm triceps (right-dominant) to below the elbow, which improved since surgery.  Physical examination showed no atrophy in the upper extremities.  Deep tendon reflexes were intact, hand grip was good, tenderness was noted at C5 to C7, and no muscle spasm was present.  Range of motion (ROM) showed flexion at 25 degrees (normal 45) and combined ROM at 250 degrees (normal 340).

At the 16 February 2007 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported pain at the base of the neck which could be elicited by physical activity and stress and was relieved by rest and medication.  He reported six incidents of incapacitating episodes, totaling 6 days over the past year.  Physical examination showed evidence of radiating pain on movement with pain radiating down to fourth and fifth fingers with no evidence of muscle spasm.  No tenderness or ankylosis of the cervical spine was noted.  ROM showed flexion at 30 degrees with pain beginning at 30 degrees and combined ROM at 245 degrees.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic neck pain 10%, coded 5241 (spinal fusion), citing cervical ROM limited by pain with localized tenderness.  The VA rated the IVDS 10%, coded 5243 based on the C&P examination, citing forward flexion of the cervical spine greater than 30 degrees and not greater than 40 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 examination proximate to separation.  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 pain, coded 5241.  

BOARD FINDINGS:  In the matter of the chronic neck pain, the panel recommends a disability rating of 20%, coded 5241 IAW VASRD §4.71a.  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 Pain, Status Post C6-7 Discectomy 	5241	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170309, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190007025, 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