RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2022-00004
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20081007

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty O4, Intelligence Officer, medically separated for “cervicalgia, previous anterior cervical fusion, herniated nucleus pulposus C6-7” with a disability rating of 10%.   

CI CONTENTION:  A one-page statement was submitted requesting review of additional conditions not identified by the Medical Evaluation Board (MEB) and/or Physical Evaluation Board (PEB) as being additionally unfitting.  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 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 - 20080910	VARD-20090326 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Cervicalgia, Previous Anterior Cervical Fusion, Herniated Nucleus Pulposus C6-7	5243	10%	Post Operative Stabilization of C6-C7 Cervical Disc Herniation Left C6-C7, T-2, T- 3 Chronic Cervical Muscle Strain	5237	10%	20090224	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%  	

ANALYSIS SUMMARY:  

Cervicalgia.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent a C6-7 anterior cervical fusion on 25 May 2007, but continued to have chronic pain, with duty and fitness limitations.  An MRI on 29 November 2006, 6 months prior to the operation showed disc herniation at C6-C7.  

The 17 April 2008 MEB NARSUM, 6 months before separation, noted complaints of chronic pain with recurrent exacerbations caused by prolonged running or standing and bending or lifting.   The next day, the MEB physical therapy range of motion (ROM) examination showed cervical spine flexion to 40 degrees (normal 45), extension to 35 degrees (normal 45), left and right lateral flexion to 30 degrees (normal 45), left lateral rotation to 55 degrees (normal 80), and right lateral rotation to 40 degrees, for a combined ROM of 230 degrees (normal 340).  

At the 24 February 2009 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported that her neck condition had improved after surgery, but she still experienced trapezius muscle tightness a couple times a week.  She rated her baseline pain at 3/10, and exacerbations in times of stress at 5/10.  Physical findings showed a normal posture and gait, with no spasm or abnormal contour.  Cervical spine flexion was to 45 degrees, extension to 45 degrees, left and right lateral flexion to 45 degrees, and left and right rotation to 80 degrees, for a combined ROM of 340 degrees; painful motion was noted during testing.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 10%, coded 5243 (intervertebral disc syndrome (IVDS)), citing the schedule for rating disabilities in use by the Department of Veterans Affairs in accordance with NDAA 2008.  The VA also rated the neck condition 10%, but coded 5237 (lumbosacral or cervical strain), based on the C&P examination, citing pain during ROM testing and X-ray evidence of cervical spine degenerative changes.  Panel 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), and/or painful motion as reported on the NARSUM and VA examinations 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.  There was no evidence of IVDS resulting in incapacitating episodes requiring physician-prescribed bed rest to warrant consideration under the alternate VASRD 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 cervicalgia 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.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20220108, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

SAF/MRB
3351 CELMERS LANE
JBA NAF WASHINGTON, MD 20762-6435

Dear XXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2022-00004.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no rating modification or re-characterization of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.

						Sincerely,