RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

 

  

SEPARATION DATE:  20040123 

 
NAME:  XXXXXXXXXXXXXXX                                                                   BRANCH OF SERVICE:  ARMY 
CASE NUMBER:  PD1200631 
BOARD DATE:  20121130      
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  a  mobilized  National  Guard,  SGT/E-5  (11B/Infantry),  medically 
separated for chronic neck pain.  The CI sustained injury to his neck while preparing to deploy in 
August 2003.  This cervical condition could not be adequately rehabilitated with treatment to 
meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical 
fitness standards.  He was issued a permanent U3 profile and referred for a Medical Evaluation 
Board (MEB).  Left Achilles tendonitis, identified in the rating chart below, was also identified 
and forwarded by the MEB as a condition meeting retention standards.  The Physical Evaluation 
Board  (PEB)  adjudicated  the  neck  condition  as  unfitting,  rated  10%,  with  application  of  the 
Department of Defense Instruction (DoDI) 1332.39.  The remaining condition was determined 
to be not unfitting.  The CI made no appeals, and was medically separated with a 10% disability 
rating.   
 
 
CI  CONTENTION:    “Qarmat  Ali  Exposure  COPD/PTSD”  was  listed  on  the  CIs  application.  He 
elaborated no specific contention in his application.   
 
 
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 other requested conditions, chronic 
obstructive pulmonary disease (COPD) and posttraumatic stress disease (PTSD), listed by the CI 
on his application, are not within the Board’s purview and will not be discussed.  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:   
 

VA (1 Mos. Post-Separation) – All Effective Date 20040124 

Service IPEB – Dated 20031211 
Condition 

Code 
5242 
Not Unfitting 

Rating 
10% 

Neck Pain 
Left Achilles Tendonitis 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

 
 
 

Condition 

Chronic neck injury with pain 
Achilles Tendonitis, Left 
PTSD 
DDD w/compression deformities 
T spine 
Tinnitus 
Migraines 

5299-5284 

Code 
5237 

9411 
5243 
6260 

8199-8100 
0% X 2 / Not Service-Connected x 3 

Combined:  90% 

Rating 
20% 
10% 
70% 
20% 
10% 
10% 

Exam 

20040226 
20040226 
20040226 
20040226 
20040217 
20040227 

 

ANALYSIS SUMMARY:  The Disability Evaluation System (DES) is responsible for maintaining a fit 
and  vital  fighting  force.    While  the  DES  considers  all  of  the  member's  medical  conditions, 
compensation  can  only  be  offered  for  those  medical  conditions  that  cut  short  a  member’s 
career, and then only to the degree of severity present at the time of final disposition.  The DES 
has neither the role nor the authority to compensate members for anticipated future severity 
or  potential  complications  of  conditions  resulting  in  medical  separation  nor  for  conditions 
determined  to  be  service-connected  by  the  Department  of  Veterans  Affairs  (DVA)  but  not 
determined to be unfitting by the PEB.  However, the DVA, operating under a different set of 
laws  (Title  38,  United  States  Code),  is  empowered  to  compensate  all  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’s role is 
confined to the review of medical records and all evidence at hand to assess the fairness of PEB 
rating  determinations,  compared  to  VASRD  standards,  based  on  severity  at  the  time  of 
separation.  
 
Neck Condition. While conducting training for deployment in March 2003, the CI fell running 
down a hill sustaining a low energy cervical whiplash injury.  He was able to deploy, but was 
evacuated back to Fort Lewis for further care in August 2003.  Routine X-rays of the cervical 
spine, obtained 12 August 2003, revealed mild to moderate degenerative changes throughout 
the lower neck.  Magnetic resonance imaging (MRI) studies of the cervical spine performed on 
15 August 2003, revealed multi-level degenerative changes, mild disc bulges at C3-4 and C5-6 
without impingement.  There were three range-of-motion (ROM) evaluations in evidence, one 
goniometric,  with  documentation  of  additional  ratable  criteria,  which  the  Board  weighed  in 
arriving at its rating recommendation; as summarized in the chart below.   

  

(20030812)  

FAROM 
FAROM 

 

Ortho Clinic ~5 Mo. Pre-Sep 

MEB ~2.5 Mo. Pre-Sep 

VA C&P ~1 Mo. Post-Sep 

(20031105)  
Full flexion  
Full extension  

- 

(20040226)  

45 without pain 

45 with pain 

290 

Cervical ROM in 

degrees 

Flexion (45 Normal) 

Extension (45) 
COMBINED (340) 

Comment 

§4.71a Rating 

Full active ROM; pain on right 
rotation and left lateral bending; 

motor/sensory/reflexes wnl 

TTP; painful motion;  5/5   

strength; sensation & 
reflexes wnl; gait wnl 

No spasm; pain in trapezius 

with motion; sensory/ 
motor/reflexes wnl 

10% 

10% 

 

10% 

 
An orthopedic clinic evaluation on 12 August 2003, 5 months before separation, full active ROM 
of  the  cervical  spine  was  noted.    Additional  findings  from  this  exam  are  noted  in  the  chart 
above.      At  the  MEB/narrative  summary  (NARSUM)  exam  performed  on  5  November  2003, 
approximately 2 months before separation, the CI reported persistent neck pain and occasional 
twinges  of  pain  in  right  arm  occurring  spontaneously  and  lasting  only  a  few  seconds.    He 
reported working full time as a manager of an information systems company without difficulty.  
Findings on physical examination are presented in the chart above.  At the VA Compensation 
and  Pension  (C&P)  exam  performed  on  26  February  2004,  a  month  after  separation,  the  CI 
reported neck pain when rotating to his right with occasional radiation to the right arm with 
numbness  and  tingling.    Findings  on  physical  examination  are  presented  in  the  chart  above.  
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB rated the neck condition 10%, using 5242, degenerative arthritis citing normal but painful 
ROM without spasm.  The VA rated the neck condition 20%, using 5237, cervical strain, with 
apparent application of §4.45.  The Board noted the CI to be right hand dominant.  The Board 
unanimously  agreed  the  examinations  supported  a  10%  rating  with  application  of  §4.59  or 
based on limited combined range of motion (C&P exam) under §4.71a ROM.  The Board agreed 
that §4.45 was not applicable, herein, given the absence in the record in evidence of objective 
quantification on examination of diminution of function with repetition.  There was no evidence 
of ratable peripheral nerve impairment in this case, since no motor weakness was present and 

   2                                                           PD1200631 
 

sensory  symptoms  had  no  functional  implication.    There  was  no  evidence  of  incapacitating 
episodes for a higher rating under 5243.  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.  As discussed above, PEB 
reliance  on  DoDI  1332.39  for  rating  neck  pain  condition  was  operant  in  this  case  and  the 
condition was adjudicated independently of that instruction by the Board.  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: 
 

UNFITTING CONDITION 

VASRD CODE  RATING 

5242 

COMBINED 

10% 
10% 

Neck Pain 

 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120607, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 
 
  
  
 
  
 
   
  
 

 

           XXXXXXXXXXXXXXXXX 
           President 
           Physical Disability Board of Review 

   3                                                           PD1200631 
 

 
 

 
 
 

 
 
 

 
 
 

 
 
 

 
 

 
 
 

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 
XXXXXXXXXXXXXXXXXXXXX, AR20120022050 (PD201200631) 
 
 
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 
 
 

     XXXXXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards) 

 
 
 

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