RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03904
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20030715

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E2, Infantry, medically separated for “pugil stick injury, left dominant wrist, healing,” with a disability rating of 10%.

CI CONTENTION:  The applicant’s condition continues to worsen and negatively impacts his daily activities.  The applicant’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 - 20030512	VARD - 20030916	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Pugil Stick Injury, Left (Dominant) Wrist	5299-5003	10%	Pugil Stick Injury, Left Wrist (Major)	5215-5014	10%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Pugil Stick Injury, Left (Dominant) Wrist.  According to the service treatment record (STR), Medical Evaluation Board (MEB), and narrative summary (NARSUM), the CI’s left wrist condition began in 2002 after a pugil stick training accident.  A bone scan revealed significant uptake in the left wrist; specifically about the scaphoid bone.  Surgery was not indicated and despite long term immobilization and aggressive physical rehabilitation, his localized painful wrist condition remained.  The MEB forwarded “left dominant wrist, healing” for PEB adjudication. 

At the MEB NARSUM examination (3 months prior to separation) the CI endorsed continued left wrist pain and the inability to perform push-ups.  His left upper extremity and wrist focused physical examination (PE) was completely normal.  X-rays indicated a small degree of degenerative change within the left wrist.  The VA utilized the CI’s STR to assist in their final rating decision.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating under an analogous 5003 code (degenerative arthritis), citing painful motion.  The VA also assigned a 10% rating using a 5215-5014 code (wrist; limitation of motion - osteomalacia) based on clinical entries within the STR.  The VASRD criteria in regards to the wrist is based upon two categories which includes either joint ankylosis (essentially, a fused joint) or limitation of motion.  In this case, the absence of a fused joint or painful motion coupled with a normal clinical examination near the time of separation would not support a positive impairment rating.  However, the radiographic finding of degenerative changes about the complex of wrist bones would support the PEB’s 10% rating.  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 left wrist condition.  

BOARD FINDINGS:  In the matter of the left 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 modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140826, 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

      In accordance with reference (a), I have reviewed the cases listed below and 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:

		- 

		- former USMC
	 	- former USN
		- former USN
		- former USN
		- former USMC
		- former USMC
		- former USMC

		

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