RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-04558 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20090227

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Light Armored Vehicle Repairer/Technician, medically separated from “C6-7 herniated nucleus pulposus with compression of left C7 nerve root” with a disability rating of 0%.

CI CONTENTION: No specific contention was made. 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 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 - 20081112	VARD - 20090608	
Condition	Code	Rating	Condition	Code	Rating	Exam	
C6-7 Herniated Nucleus Pulposus …	5243	0%	Cervical Disc Disease	5242	10%	20090608	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: 30%	

ANALYSIS SUMMARY:

C6-7 Herniated Nucleus Pulposus. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI had a pre-enlistment neck injury and an onset of persistent neck pain during basic training with no specific injury. An MRI performed in July 2008 demonstrated a herniated disc at C6/7 with left nerve root compression. Surgery was recommended but deferred by the CI. There were no STR entries that documented any significant range of motion (ROM) limitation, painful motion, abnormal gait or spinal contour, incapacitating episodes or other VASRD-ratable findings.

The 21 July 2008 MEB NARSUM examination, 7 months prior to separation, recorded nonspecific neck pain that was aggravated by neck extension, lifting, pushing, and pulling. Physical examination revealed a normal gait without note of abnormal spinal contour, and tenderness without mention of spasm. The 28 October 2008 MEB NARSUM addendum, 4 months before separation, documented cervical spine flexion to 45 degrees (normal) and a combined ROM of 185 degrees (normal 340); painful motion was not addressed.

At the 8 June 2009 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported constant neck pain and stiffness that was aggravated by quick head movement or prolonged fixation of head position. The examiner documented the absence of any incapacitating episodes. Physical examination revealed a normal gait and spinal contour with no tenderness, spasm or guarding. Neck flexion was to 45 degrees and combined ROM was 340 degrees. Painful motion was not specified, although the examiner commented that there was pain with neck hyperextension. There was no ROM loss following repetitive motion due to pain, fatigue, weakness, lack of endurance, or incoordination.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the cervical spine condition 0%, coded 5243 (intervertebral disc syndrome (IVDS)). The VA rated the condition 10%, coded 5242 (degenerative arthritis of the spine), based on the C&P examination, citing limitation of combined ROM. Panel members deliberated over whether the determinant probative value for the panel’s recommendation should be assigned to the MEB NARSUM addendum or C&P evidence, and ultimately agreed on the addendum, as this examination was nearly as temporally probative as the VA examination, and there was no indication that it was not compliant with VASRD §4.46 (accurate measurement). The panel therefore agreed that a 10% rating, but no higher, was justified for combined ROM (greater than 170 degrees but not greater than 335 degrees). There was no evidence for abnormal gait or spinal contour to support the next higher 20% rating, and no documentation of IVDS with incapacitating episodes which would provide for a higher rating under that formula. After due deliberation, considering all the evidence and conceding VASRD §4.3 (reasonable doubt), the panel recommends a 10% rating for the cervical spine condition, coded 5242.

BOARD FINDINGS: In the matter of the cervical spine condition, the panel recommends a disability rating of 10%, coded 5242 IAW VASRD §4.71a. There are no other conditions within the panel’s scope of review for consideration.

The panel recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Cervical Disc Disease	5242	10%	

2	PD-2017-04558

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COtnlCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO:
1850
CORB:003 12 Oct 20

From: To:

Subj:

Ref:

Director, Secretary of the Navy Council of Review Boards 
PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

(a) DoDI 6040.44
(b)	PDBR ltr of 6 Dec 19
(b)	

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy for appropriate action.
2.	On s October 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) took action in your case by accepting the recommendation of the PDBR. Accordingly, your records will be corrected to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEE) from 0% to 10% without re-characterization of your discharge.

3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	The Assistant Secretary's determination, which represents final action in your case by the Department of the Navy, has been forwarded to the office of the Deputy Commandant, Manpower and Reserve Affairs, for appropriate changes to your personnel records and notification to you upon completion.