RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE:  PD-2014-02970
BRANCH OF SERVICE:  mARINE cORPs		SEPARATION DATE:  20090429

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E1, Basic Trainee, medically separated for “right distal radius fracture,” with a disability rating of 10%.

CI CONTENTION:  “The PEB board stated that the injury was a direct result of a combat related injury.  The VA disagreed and I had my severance pay recouped.”  The CI’s complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited 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 PEB, but determined to be not unfitting.  Any conditions outside the Board’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.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation.  The Board 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, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.  

RATING COMPARISON:

SERVICE PEB - 20090316	VARD - 20091026	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Distal Radius Fracture	5212	10%	Surgical Residuals, R Distal Radius Fracture	5212	10%	20091002	
Status Post-Surgical Treatment	Category II					
COMBINED RATING:  10%	COMBINED RATING FOR ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Right Distal Radius Fracture.  The service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM) documented a right (dominant) distal radius wrist fracture early in basic training (6 months prior to separation) which required surgical intervention (open reduction, internal fixation).  Outpatient STR entries documented an uncomplicated course with recovery of good range of motion (ROM), although there were conflicting post-operative X-ray reports with regard to the possibility of “some” dorsal angulation of the healed fracture.  It was judged that anticipated time to full recovery was too long for resuming basic training, and the MEB forwarded the diagnoses “other closed fractures of distal end of radius (alone)” and “other postsurgical status” to the PEB for adjudication.  The NARSUM was conducted 19 February 2009 (2 months before separation) and documented the above clinical course without elaboration of pain severity or specific functional limitations.  The NARSUM physical examination recorded a healed surgical incision with “minimal tenderness,” no deformity, and normal strength and sensation.  The NARSUM measured ROM was dorsiflexion to 70 degrees (70 normal) and palmar flexion to 70 degrees (normal 80), and also noted normal pronation and supination (more specific to elbow).  Equivalent ROM measurements were corroborated in STR entries and the MEB’s DD Form 2808, which also documented painful motion.  

A VA Compensation and Pension (C&P) examination was conducted 2 October 2009 (2 months after separation) and documented an improving course, specifying “no significant effects” on occupation and no limitation of normal activities.  The VA physical examination recorded “no tenderness at this time” and the absence of deformity or neurologic abnormalities.  The VA measured ROM was normal in all planes, annotating painful motion and no decrease with repetition.

The Board directed attention to its rating recommendation based on the above evidence.  It was first clarified that the PEB’s Category II diagnosis (surgical residuals) was intrinsic to the rated condition such that a separate rating could not be supported without pyramiding (VASRD §4.14), and thus was appropriately subsumed in the same rating.  Both the PEB and the VA conferred a 10% rating under code 5212 (radius, impairment of), conceding the presence of malunion.  No criteria for a higher rating under code 5212 were supported by the evidence, and no rating higher than 10% was supported under any other joint or analogous code available in VASRD §4.71a.  After due deliberation, and in consideration of all 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 of the right wrist condition.

BOARD FINDINGS:  In the matter of the right wrist 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.  The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140617 w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 15 Apr 16

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXX, former USN