RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX  	CASE:  PD-2017-02968
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050903

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Field Artillery Fire Direction Specialist, medically separated for “history of a C5 crush fracture” 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 (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 - 20050809	VARD - 20051223	
Condition	Code	Rating	Condition	Code	Rating	Exam	
History of a C5 Crush Fracture	5235-5241	10%	C5 Fracture, S/P C4-6 Fusion	5237	10%	20051005	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

History of a C5 Crush Fracture.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent emergent C-spine fusion neck surgery in July 2003 in Iraq.  Cervical spine X-rays from April 2005 revealed anterior plate and screw bridging of C4-6 with solid bony fusion.  The 8 July 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of neck pain and reduced range of motion (ROM) of the neck.  The ROM evaluation showed 45 degrees of flexion (normal) and 170 degrees of combined ROM (normal 340), after repetitive motion, with mild pain.  

At the 5 October 2005 VA Compensation and Pension (C&P) examination, 1 month after separation, the CI reported constant neck pain with flare-ups.  On examination, gait and station were normal.  Motor strength was normal in all four extremities.  The ROM evaluation showed flexion of 45 degrees and combined ROM of 195 degrees.  Pain was not elicited with any of these maneuvers and there was no evidence of weakness, fatigue or decreased endurance.  No significant neurological deficits were noted.  

During the 30 November 2005 VA physical therapy (PT) clinic appointment, 3 months after separation, the examiner noted strong and pain free neck and upper extremities, but there was mild tenderness over the cervical spine.  The ROM evaluation showed 45 degrees of flexion, but combined ROM could not be calculated.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 10%, dual coded 5235-5241 (vertebral fracture-spinal fusion), citing pain limited ROM.  The VA also rated the neck condition 10%, coded 5237 (cervical strain), based on the C&P examination, citing combined ROM of the cervical spine greater than 170 degrees but not greater than 335 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 VA C&P examination most proximate to separation.  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.  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 20170421, w/atchs  
Exhibit B.  Service Treatment Record  
Exhibit C.  Department of Veterans Affairs Record  

AR20190008782, XXXXXXXXXXXXXXXXXX 

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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.