NAME:  XXXXXXXXXXXXXXXXXXXXXXX                                                BRANCH OF SERVICE:  ARMY 
CASE NUMBER:  PD1200504                                                                  SEPARATION DATE:  20020902 
BOARD DATE:  20121119 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  SPC/E-4  (63J10/Chemical  and  Quartermaster 
Equipment Repair), medically separated for neck pain.  The condition began with ruck marching 
during basic training in 2000, 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 or satisfy physical fitness standards.  She was issued a permanent U4 
profile and referred for a Medical Evaluation Board (MEB).  The MEB forwarded non-radicular 
neck  pain  with  degenerative  arthrosis  at  facets  C7-T1  and  T1-T2  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 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:  “Arthritis is degenerative and continues to get worse.  Has negatively affected 
my ability to be a mom or have more children.  I have attached all letters and documents I have 
sent in during this whole process, since I have yet to hear anything about my initial appeal.  I 
apologize if you don’t need these but I thought the more info the better.” 
 
 
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.    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 the Correction of Military Records. 
 
 
RATING COMPARISON: 
 

Service PEB – Dated 20020521 

VA (~1 Mo. Pre-Separation) – All Effective Date 20020903 

Condition 

Neck Pain 

Code 

5099-5003 

Rating 
10% 

Condition 

Osteoarthritis Upper Back and Neck 

Code 
5010 

Rating 
10% 

Exam 

20020730 
20020730 

0% X 2 
Combined:  10%* 

RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

*VA decision 20110919 rated upper back separately from neck, at 10%, effective 20110103; combined 20% 
 
 
ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application 
regarding the significant impairment with which her service-aggravated 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  service  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  its  recommendations;  and, 
DoDI  6040.44  defines  a  12-month  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. 
 
Neck  Pain  (non-radicular)  Condition.    The  2002  VASRD  coding  and  rating  standards  for  the 
spine, which were in effect at the time of separation, were changed to the current §4.71a rating 
standards in 2004, and were identical to the 2002 VASRD standards used by the VA in its initial 
rating decision.  The pre-2004 ratings were based on a judgment as to whether the disability 
was mild, moderate or severe.  The 2004-to-current standards are grounded in range of motion 
(ROM) measurements.  IAW DoDI 6040.44, this Board must consider the appropriate rating for 
the  CI’s  back  condition at  separation  based  on the  VASRD  standards  in  effect  at the time of 
separation (i.e. pre-2004 standards).   Although the CI suffered a neck injury at age 15 during 
gymnastics, her neck pain subsided until she was required to perform activities of basic training.  
Ongoing  pain  did  not  respond  to  physical  therapy,  chiropractic  care  or  medication.    X-rays 
showed arthritic changes of the facet joints of C-7 through T2, and decreased disc space at C6-
7.    A  bone  scan  was  negative  and  magnetic  resonance  imaging  (MRI)  was  normal.    At  the 
narrative  summary  (NARSUM)  exam  on  3  April  2002,  5  months  prior  to  separation,  the  CI 
reported an inability to carry a rifle, lift more than 15 pounds or wear any professional gear due 
to pain only at the base of her neck.  She denied radiation of pain or upper extremity numbness 
or  tingling.    She  was  taking  no  medication.    Physical  examination  noted  a  normal  gait.  
Tenderness was present at the area of the C7 and T1 vertebrae.  Range-of-motion (ROM) of the 
neck  and  thoracic  spine  was  considered  to  be  “full.”    Neurologic  findings  of  the  upper 
extremities were normal.  At an outpatient primary care clinic visit on 13 May 2002, 4 months 
prior to separation, the CI complained of constant burning and tingling present for several days.  
Exam revealed full ROM of the cervical and thoracic spine.  No tenderness was present.  At an 
emergency room visit on 13 June 2002, 3 months prior to separation, to evaluate a complaint of 
head trauma, the examination noted the neck and spine to be non-tender and to exhibit full 
ROM.   
 
At the VA Compensation and Pension (C&P) exam on 30 July 2002, a month prior to separation, 
the CI reported that her pain was constant at a severity of seven on a 0-10 scale.  Prolonged 
driving, certain weather changes, walking, computer work or any lifting made it worse.  Pain 
interfered with her sleep.  She denied numbness, tingling or weakness of her upper extremities.  
She  took  anti-inflammatory  medication  for  pain.    Physical  examination  revealed  a  normal 
posture, gait and spinal contour.  Tenderness of the C6 to T2 vertebral regions was present.  No 
trapezius muscle spasm was present.  Muscle strength of the arms was normal.  ROM testing 
revealed  flexion  of  60  degrees;  normal  was  considered  to  be  65  degrees  by  that  examiner, 
although  45  degrees  is  normal  by  current  standards.    Extension  was  25  degrees  (normal  45 
degrees  by  current  standards),  lateral  flexion  30  degrees  bilaterally  (normal  45  degrees  by 
current  standards),  and  rotation  55  degrees  bilaterally  (normal  80  degrees  by  current 
standards).  Painful motion was evident.  After five repetitions, ROM was reduced to 25 degrees 
for right lateral flexion, and 45 degrees for right and left rotation.  Flexion and extension were 
unchanged, while left lateral rotation increased to 35 degrees. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  and  VA  both  assigned  a  10%  rating  under  an  arthritis  code;  the  PEB  used  an  analogous 
5003 code (degenerative arthritis) while the VA used 5010 (traumatic arthritis).  IAW §4.71a, a 
rating is based on limitation of motion.  Although limited motion was apparently not present on 
the  NARSUM  exam  (specific  measurements  were  not  provided),  and  two  subsequent  clinical 

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examinations  also documented normal  ROM,  the  PEB’s  10%  rating  was  justified under  §4.40 
(functional loss) or §4.59 (painful motion).  The findings on the VA exam justified a 10% rating 
under the 5290 code for “slight” limitation of motion.  The Board debated if a higher rating was 
warranted  using  the  older  VASRD  rules  in  effect  at  the  time.    Board  members  agreed  that 
“moderate” limitation of motion supporting a 20% rating was not present on any of the cited 
examinations, and further noted that there was no evidence of “moderate recurring attacks” 
that would justify a higher rating under the 5293 code (intervertebral disc syndrome).  Board 
members  also  agreed  that  a  higher  rating  was  not  justified  under  §4.45,  since  additional 
limitation of motion after repetitive motion on the VA exam was minimal.  The Board finally 
considered  if  symptoms  and  findings  warranted  disability  ratings  under  two  separate  codes 
(limitation of cervical spine motion and limitation of dorsal spine motion).  Under the VASRD in 
effect at the time, “both under ankylosis and limited motion, ratings should not be assigned for 
more  than  one  segment  by  reason  of  involvement  of  only  the  first  or  last  vertebrae  of  an 
adjacent  segment.”    Board  members  agreed  that  involvement  of  the  lowermost  cervical 
vertebra and uppermost thoracic vertebra in this case represented such an “adjacent segment.”  
Furthermore, assigning two separate ratings in this case was not warranted IAW VASRD §4.14 
(avoidance of pyramiding).  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 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 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 
5099-5003 
COMBINED 

10% 
10% 

Neck Pain 

UNFITTING CONDITION 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120604, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 

 

           XXXXXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

   3                                                           PD1200504 
 

 
 

 
 
 

 
 
 

 
 
 

 
 
 

 
 

 
 
 

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 
XXXXXXXXXXXXXXXXXXXXXXXXX, AR20120021424 (PD201200504) 
 
 
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 
 
 

     XXXXXXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards) 

 
 
 

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