RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02643
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050909

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Carpentry/Masonry Specialist, medically separated for “chronic neck pain” with a disability rating of 10%.  

CI CONTENTION:  The condition continues to worsen and negatively affects his activities.  He also requested review of an additional condition 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 - 20050808	VARD - 20050915	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Neck Pain	5299-5237	10%	Cervical Spine Spondylosis	5242	20%	20050802	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Neck Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s neck condition began in September 1987 after a motor vehicle accident.  He had a break in service and reenlisted in October 2003, and was able to perform all of his military duties until October 2004, when he began having upper back and neck pain with some tingling in the arms. Cervical X-rays showed degenerative arthritis, and a subsequent MRI and CT myelogram showed herniated and bulging discs at C4-5 and C5-6 with an osteophyte complex producing flattening of the spinal cord and mild bilateral neural foraminal stenosis.  A neurosurgeon diagnosed cervical spondylosis without myelopathy, but advised against surgery.  
The 21 June 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, showed tenderness.  The range of motion (ROM) evaluation revealed pain-limited flexion of 35 degrees (normal 45) and combined ROM of 200 degrees (normal 340).  The 30 June 2005 MEB NARSUM examination, 2 months before separation, repeated the above findings.  

At the 2 August 2005 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported constant 8/10 neck pain elicited by physical activity and stress, but he denied incapacitation.  Physical examination showed tenderness, normal posture and gait, and no evidence of muscle spasm or radiating pain on movement.  The ROM study showed flexion of 40 degrees and combined ROM of 230 degrees, with pain-limiting motion in all planes except for extension.  The examiner noted the cervical spine joint function was additionally limited by pain, but was unable to determine the amount in degrees without resorting to speculation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 10%, analogously coded 5299-5237 (cervical strain), citing cervical ROM limited by pain with localized tenderness.  The VA rated the neck condition 20%, coded 5242 (degenerative arthritis of the spine), based on the C&P examination, citing “evidence of degenerative changes of the cervical spine resulting in significant limitation of forward flexion.”  Members agreed that a 10% rating, but no higher, was justified for limitation of flexion (greater than 30 degrees but not greater than 40 degrees) and/or combined ROM (greater than 170 degrees but not greater than 335 degrees) 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 chronic neck pain 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 20170318, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR, 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