RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05776
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080828

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Patriot Fire Control Enhanced Operator/Maintainer, medically separated for “neck pain” with a disability rating of 10%.  

CI CONTENTION:  The condition continues to worsen and negatively affects daily activities.  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in Do DI 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 - 20080607	VARD - 20081231	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Neck Pain 	5299-5243	10%	Degenerative Disc Disease	5003-5237	10%	20081119	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:  

Neck Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s neck condition began in June 2006 while crawling on his hands and knees with another soldier hanging from his neck who was rather large and cumbersome.  The 10 June 2008 MEB NARSUM examination, 2 months prior to separation, noted complaints of neck pain which radiated into his arms and caused headaches.  Physical examination showed a normal stance and gait.  Motor strength and reflexes were normal, and sensation was grossly intact.  Hoffman's sign (test for corticospinal tract issues) was negative.  There was no paraspinal tenderness, guardian or spasm noted.  Cervical spine range of motion (ROM) testing by physical therapy (PT) showed flexion of 45 degrees (normal) and combined ROM of 295 degrees (normal 340), after repetition.  The examiner noted limited right lateral flexion and right rotation seemingly limited by pain and not structural abnormality.  There was a slight increase in upper thoracic kyphosis (curvature).  

At the 19 November 2008 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported neck pain.  Physical examination showed normal neck ROM, but there was painful motion with grimacing at extremes of lateral flexion and lateral rotation bilaterally.  There were no additional limitations of movement due to pain, fatigue, incoordination, weakness or lack of endurance after repetitive motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 10%, analogously coded 5299 5243 (intervertebral disc syndrome), citing pain-limited ROM.  The panel agreed the PEB properly subsumed MEB diagnosis 2, “axial spine limiting activity” into the rating for the neck to avoid pyramiding (VASRD §4.14).  The VA also rated the neck condition 10%, analogously coded 5003-5237 (degenerative arthritis-cervical strain), based on the C&P examination, citing painful motion.  Panel members agreed a 10% rating for limitation of combined motion (greater than 170 degrees but not greater than 340 degrees) was supported by the MEB NARSUM proximate to separation.  Alternatively, a 10% rating was justified for the presence of painful motion.  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 evidence of intervertebral disc syndrome which resulted in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration of rating under the alternate VASRD formula for that condition.  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. 

ARXXXXXXXXXXX, XXXXXXXXXXXXXX

Dear XXXXXXXXXX:

	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