RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXXXXXXXXXXXXXXX                                                                 BRANCH OF SERVICE:   ARMY 
CASE NUMBER:  PD1200435 
SEPARATION DATE:  20050531 
BOARD DATE:  20121116 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active Guard Reserve SGT/E-5 (71L20/Administrative Specialist), 
medically separated for chronic neck pain.  The condition began in 1999 subsequent to a motor 
vehicle  accident  (MVA),  and  was  not  associated  with  a  surgical  indication.    The  CI  did  not 
improve  adequately  with  treatment  to  meet  the  physical  requirements  of  her  Military 
Occupational Specialty (MOS) or satisfy physical fitness standards.  She was issued a permanent 
U3  profile  and  referred  for  a  Medical  Evaluation  Board  (MEB).    The  MEB  forwarded  chronic 
neck pain to the Physical Evaluation Board (PEB) as medically unacceptable IAW AR 40-501.  No 
other  conditions  appeared  on  the  MEB’s  submission.    The  PEB  adjudicated  the  chronic 
subjective neck pain condition as unfitting, rated 10% with application of the Veteran’s Affairs 
Schedule for Rating Disabilities (VASRD).  The CI made no appeals, and was medically separated 
with a 10% disability rating. 
 
 
CI CONTENTION:  “ On 28 October I was diagnosed with "left wrist tendinitis: and awarded a P3, 
but after further review of my conditions the MMRB process on 26 October 2004 it was decided 
to send me to MEB for neck pain with a P3 for left wrist tendinitis. The MEB awarded me a 10% 
disability  with  severance  pay.    I  consider  this  determination  incorrect  since  my  EMG  dated 
14 April  2004  revealed  that  I  had  carpal  tunnel  syndrome.    The  MRI  dated  on  9  July  2004 
indicated (cervical radiculopathy) disk bulges and D.D.D.  I was receiving therapy for my neck, 
back and wrist.  They change my therapy to Rodriguez Army Health Clinic and my back pain was 
never attend again.  The final decision was made with a P3 profile that was incorrect and a new 
profile never was made.  My treatment was incomplete and I want a fair decision about my 
conditions, now I have arthritis on my neck and lower back.  VA assign me a wheelchair and 
wrist brace to treat those conditions.  I have others LOD that never was sign by my Commander 
just the clinic.” [sic] 
 
 
SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44 (Enclosure 3, paragraph 5.e.(2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.”  The ratings 
for  unfitting  conditions  will  be  reviewed  in  all  cases.  The  wrist  tendinitis,  carpal  tunnel 
syndrome and low back pain conditions are not within the Board’s purview.  Any conditions or 
contention not requested in this application, or otherwise outside the Board’s defined scope of 
review, remain eligible for future consideration by the Army Board for Correction of Military 
Records. 
 
 
 
 
 

 
 
 
RATING COMPARISON:   
 

Service IPEB – Dated 20050103 
Condition 

Code 

Chronic Subjective Neck 
Pain 

5299-5237 

Rating 
10% 

↓No Additional MEB/PEB Entries↓ 

Cervical ROM 

Flex (45⁰ Normal) 

Ext (0-45) 

R Lat Flex (0-45) 
L Lat Flex (0-45) 

45⁰ 
45⁰ 
45⁰ 
45⁰ 

30⁰ 
10⁰ 
45⁰ 
45⁰ 

VA (6 Mos. Post-Separation) – All Effective Date 20050601 

Condition 

Code 
5243 
5243 

Cervical Degenerative Disc 
Disease 
Chronic Low Back Pain – DDD 
Right Knee Tendinitis 
Left Carpal Tunnel Syndrome 
Right Carpal Tunnel Syndrome 
Right Shoulder Bursitis 

5299-5257 
5299-8515 
8599-8515 
5019-5024 
0% X 2 / Not Service-Connected x 1 

Combined:  70% 

Rating 
20% 
40% 
10% 
10% 
10% 
10% 

Exam 

20051215 
20051215 
20050726 
20050726 
20050726 
20051215 
20050726 

Combined:  10% 

its  recommendations;  and,  DoDI  6040.44  defines  a  12-month 

 
 
ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding the gravity of her condition and the significant impairment with which her service-
connected  condition  continues  to  burden  her.    It  is  a  fact,  however,  that  the  Disability 
Evaluation  System  (DES)  has  neither  the  role  nor  the  authority  to  compensate  members  for 
anticipated  future  severity  or  potential  complications  of  conditions  resulting  in  medical 
separation.    This  role  and  authority  is  granted  by  Congress  to  the  Department  of  Veterans’ 
Affairs (DVA).  The DVA, operating under a different set of laws (Title 38, United States Code), is 
empowered to compensate service-connected conditions and to periodically re-evaluate said 
conditions  for  the  purpose  of  adjusting  the  Veteran’s  disability  rating  should  the  degree  of 
impairment vary over time.  The Board utilizes DVA evidence proximal to separation in arriving 
at 
interval  for  special 
consideration to post-separation evidence.  The Board’s authority as defined in DoDI 6044.40, 
however, resides in evaluating the fairness of DES fitness determinations and rating decisions 
for disability at the time of separation.  Post-separation evidence therefore is probative only to 
the  extent  that  it  reasonably  reflects  the  disability  and  fitness  implications  at  the  time  of 
separation.  The Board further acknowledges the CI’s assertions that a profile was incorrectly 
assigned, medical treatment was incomplete and a commander did not sign an LOD; but, must 
note  for  the  record  that  it  has  neither  the  jurisdiction  nor  authority  to  scrutinize  or  render 
opinions in reference to such allegations.  The Board’s role is confined to the review of medical 
records  and  all  evidence  at  hand  to  assess  the  fairness  of  service  rating  and  fitness 
determinations at separation, as elaborated above. 
 
Neck Condition.  Although the CI experienced mild neck pain following a MVA in July 1999, the 
clinical record is silent regarding neck complaints until 2002.  Persistent neck pain associated 
with  hand  numbness  and  elbow  pain  led  to  electrodiagnostic  studies  (EMG)  performed  on 
21 June  2004  which  showed  no  evidence  of  cervical  radiculopathy.    A  magnetic  resonance 
imaging  (MRI)  study  performed  on  7  July  2004  showed  some  disc  bulging  at  C3  through  C6.  
There  were  two  goniometric  range-of-motion 
in  evidence,  with 
documentation of additional ratable criteria, which the Board weighed in arriving at its rating 
recommendation; as summarized in the chart below.   
 

(ROM)  evaluations 

MEB ~6 Mo. Pre-Sep 

VA C&P ~6 Mo. Post-Sep 

R Rotation (0-80) 
L Rotation (0-80) 
COMBINED (340⁰) 

Comment 

§4.71a Rating 

80⁰ 
80⁰ 
340⁰ 

 

10%* 

80⁰ 
80⁰ 
290⁰ 

20% 

+Tenderness, spasm 

                          *Conceding pain with use 
 
At the narrative summary (NARSUM) examination, the CI reported that flare-ups of neck pain 
occurred 2-3 times per week.  Driving, computer work and reading exacerbated the condition.  
Medications, physical therapy and rest were helpful.  The physical examination noted a normal 
gait,  but  was  silent  regarding  spinal  contour  or  objective  evidence  of  pain.    Neurologic 
examination was normal.  A VA Compensation and Pension (C&P) exam performed on 26 July 
2005, an erect posture and normal gait were noted.  Limitation of flexion and extension were 
observed,  but  measurements  were  not  performed.    Tenderness  and  spasm  of  paracervical 
muscles was present, but spinal contour was not reported.  At a spine C&P exam 6 months after 
separation, the CI reported constant neck pain and stiffness.  She required 3 days of rest during 
the  prior  year  for  her  spine  condition.    Physical  examination  noted  normal  gait  and  spinal 
contour.    Upper  extremity  strength  and  deep  tendon  reflexes  (DTRs)  were  normal,  but 
diminished pinprick sensation was noted in the upper extremities. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and VA chose different coding options for the condition, but this did not bear on the rating.  
The 10% rating by the PEB was based on appropriate application of functional loss (§4.40) in the 
setting of normal ROM.  The Board considered that the exam was silent regarding other criteria 
for  a  higher  rating,  namely  muscle  spasm  or  guarding  severe  enough  to  result  in  abnormal 
spinal  contour.    However,  Board  members  agreed  that  completely  normal  ROM  testing  was 
incompatible  with  the  presence  of  muscle  spasm  severe  enough  to  cause  abnormal  spinal 
contour.  The 20% rating assigned by the VA was also appropriate given the limitation of flexion 
noted by the VA examiner.  In its assignment of probative value to such disparate exams, which 
were  equally  proximate  to  separation,  the  Board  must  acknowledge  that  VA  goniometric 
examinations  may  predispose  to  a  lowered  pain  threshold  since  they  are  vulnerable  to  the 
compelling psychological influence of secondary gain.  Upon deliberation the Board agreed in 
this  case  that  the  MEB  examination  was  more  consistent  with  outpatient  notes,  and  less 
vulnerable to the undue influence just elaborated.  The Board is therefore relying more heavily 
on the MEB measurements.  The Board also considered rating intervertebral disc disease under 
the alternative formula for incapacitating episodes, but could not find sufficient evidence which 
would  meet  even  the  10%  criteria  under  that  formula.    The  Board  further  deliberated  if 
additional disability was justified for the history of radiating pain and numbness suggestive of 
radiculopathy.  Examiners however recorded normal muscle strength testing.  The MRI showed 
evidence  of  disc  bulging,  but  the  EMG  showed  no  evidence  of  cervical  radiculopathy.    The 
presence of functional impairment with a direct impact on fitness is the key determinant in the 
Board’s decision to recommend any condition for rating as additionally unfitting.  There is no 
evidence in this case of functional impairment attributable to cervical radiculopathy, and the 
Board therefore concludes that additional disability was not justified on this basis.  After due 
deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the 
Board  concluded  that  there  was  insufficient  cause  to  recommend  a  change  in  the  PEB 
adjudication for the chronic neck pain condition. 
 
 
BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or 
guidelines relied upon by the PEB will not be considered by the Board to the extent they were 

inconsistent  with  the  VASRD  in  effect  at  the  time  of  the  adjudication.    The  Board  did  not 
surmise  from  the  record  or  PEB  ruling  in  this  case  that  any  prerogatives  outside  the  VASRD 
were exercised.  In the matter of the chronic neck pain condition and IAW VASRD §4.71a, the 
Board  unanimously  recommends  no  change  in  the  PEB  adjudication.    There  were  no  other 
conditions within the Board’s scope of review for consideration. 
 
 
RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows: 
 

VASRD CODE  RATING 
5299-5237 
COMBINED 

10% 
10% 

           XXXXXXXXXXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

Chronic Subjective Neck Pain 

UNFITTING CONDITION 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120517, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 
 

 

 
 

 
 
 

 
 
 

 
 
 

 
 
 

 
 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB /  ), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXXXXXXXX, AR20120021216 (PD201200435) 
 
 
I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD 
PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under 
the authority of Title 10, United States Code, section 1554a,   I accept the Board’s 
recommendation and hereby deny the individual’s application.   
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress 
who have shown interest in this application have been notified of this decision by mail. 
 
 BY ORDER OF THE SECRETARY OF THE ARMY: 
 
 
 
 
Encl 
 
 
 
CF:  
(  ) DoD PDBR 
(  ) DVA 
 
 

     XXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)