RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02925
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20060629

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

CI CONTENTION:  “My injury has gotten worse.”  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 - 20060326	VARD - 20050909	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Neck Pain	5241	10%	Residuals, Cervical Fusion of C6-C7	5235-5241	10%	20050627	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Neck Pain.  According to service treatment record and MEB narrative summary (NARSUM), the CI presented in March 2005 for severe neck stiffness after an 18-month history and reported no injury or trauma.  On 2 March 2005, an MRI revealed a C6-C7 broad disc herniation, and on 31 March 2005, he underwent a C6-C7 anterior cervical discectomy and fusion.  The neck pain continued, and the CI was treated with a neck brace and occupational therapy.

At the 27 June 2005 VA Compensation and Pension (C&P) examination, 12 months before separation, and 3 months after surgery, the CI reported persistent neck pain that did not radiate and was not debilitating.  Physical examination revealed no neck tenderness, swelling or deformities.  Range of motion (ROM) showed flexion to 30 degrees (normal 45) and a combined ROM of 160 degrees (normal 340); painful motion was absent.  

During the 21 September 2005 MEB examination (recorded on DD Forms 2807 and 2808), 9 months before separation, the provider noted neck tenderness and “decreased” ROM.  An MRI on 4 December 2005 revealed minimal C6-C7 central and foraminal stenosis.  At the 16 February 2006 MEB NARSUM examination, 4 months prior to separation, the CI complained of neck pain rated at 10/10 (despite medication use) and bilateral bicep and tricep muscle spasms without radiating pain.  The examiner documented a normal gait and posture, no upper or lower extremity stiffness, strength at 5/5, and intact sensation; ROM was not recorded.  At the 2 March 2006 MEB orthopedic examination, 3 months before separation, physical examination showed flexion to 30 degrees and a combined ROM of 115 degrees, with painful motion. 

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck pain condition 10%, coded 5241 (spinal fusion), citing pain limited motion.  The VA also rated the neck condition 10%, analogously coded 5235-5241 (vertebral fracture or dislocation-spinal fusion), based on the C&P examination, citing limitation of motion.  Panel members 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 MEB orthopedic and VA examinations.  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 of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the neck pain condition, coded 5241.

BOARD FINDINGS:  In the matter of the neck pain condition, 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 as of the date of the prior medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Neck Pain	5241	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170312, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180008797, 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