RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04351
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20041022

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4, Administrative Specialist, medically separated for a dominant ring finger condition with a disability rating of 0%.  

CI CONTENTION:  “The applicant makes no specific contention in her application.  Her 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 based upon a 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:  

IPEB - Dated 20040819	VARD- 20050201	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right (Dominant) Ring Finger, Unable To Fully Extend Dip Joint	5230	0%	Right 4th Finger Tendon Repair Surgery With Residuals	5230	0%	20040616	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Right (Dominant) Ring Finger, Unable To Fully Extend Dip Joint Condition.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s finger condition began in March 2003 after while playing flag football.  The CI was diagnosed with a flexor digitorum profundus (FDP) avulsion and underwent a reconstruction and (July 2003) and rod placement (October 2003).  The CI continued to report right hand pain and weakness.  The condition could not be adequately rehabilitated to meet the physical requirements of her Military Occupational Specialty (MOS).  The MEB forwarded “pain and weakness (slight/intermittent) of the right ring finger” for PEB adjudication.  
The MEB NARSUM examination on 22 June 2004, 4 months prior to separation, noted complaints pain and some weakness in her right ring finger.  The physical examination showed decreased flexion of the right ring finger distal interphalangeal (DIP) joint to 40 degrees (normal 90).  At the 16 June 2004 VA Compensation and Pension (C&P) evaluation, performed 4 months before separation, the CI reported constant weakness, poor grip, tender wrist, and pain when carrying heavy weight.  The physical examination revealed that the CI had difficulty tying shoelaces with the right hand and difficulty fastening buttons with the right hand.  She could pick up a piece of paper and tear it without difficulty.  She also had a decrease right ring finger DIP joint flexion to 5 degrees (normal 90).  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right ring finger condition 0%, coded 5230 (Ring or little finger, limitation of motion), citing limitation of motion.  The VA also rated the right ring finger condition 0% coded 5230 (Ring or little finger, limitation of motion), based on the VA C&P examination 4 months before separation, citing DIP flexion of 5 degrees with pain.  The Board considered its rating recommendation for right ring finger condition based on the VASRD diagnostic code for the ring or little finger, limitation of motion (5230).  0% is the highest rating available under this code. Both the MEB NARSUM and the VA C&P examinations were at essentially the same time, 4 months before the date of separation and were adjudged to have equal probative value for rating.  The Board considered a separate rating using an analogous coding of ring or little finger, ankylosis (5226) or DIP amputation; however, the highest rating is 0%.  The Board also considered whether evaluation as amputation was warranted and whether an additional evaluation was warranted for resulting limitation of motion of other digits or interference with overall function of the hand.  Only the distal joint (DIP) of the ring finger had limited ROM and overall the finger had good functional use.  There was sufficient evidence that the CI had pain specific to the use of the right ring finger with a demonstrated limitation of motion supporting a 10% rating (based on §4.59, §4.40 and §4.45).  The CI’s disability picture did not approach loss of use of the finger for any rating higher than 10%.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the right ring finger condition.  

BOARD FINDINGS:  In the matter of the right ring finger condition, the Board unanimously or majority recommends a disability rating of 10%, coded 5230 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  

The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Right (Dominant) Ring Finger…	5230	10%	

The following documentary evidence was considered:

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

SAMR-RB										

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for, AR20160018421 (PD201404351)

1.  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, accept the Board’s recommendation to modify the individual’s disability rating to 10% without re-characterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

 BY ORDER OF THE SECRETARY OF THE ARMY:

CF: 
(  ) DoD PDBR
(  ) DVA