RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00129
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20080121

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Munitions Systems Journeyman, medically separated for “chronic left elbow and forearm pain, status post ulnar nerve transposition for cubital tunnel syndrome” with a disability rating of 10%.

CI CONTENTION:  The CI requests the Board consider the ratings for his left forearm, elbow, cubital tunnel syndrome, low back degeneration, and TMJ.  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 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:  

SERVICE PEB - 20071106	VARD - 20090707	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Forearm and Elbow Pain	8716	10%	Status Post Left Ulnar Nerve Transposition Surgery with Scar	8516	0%	20090504	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Left Forearm and Elbow Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent left ulnar nerve transposition in June 2006 for cubital tunnel syndrome.  A nerve conduction study performed May 2007 was normal.  The MEB NARSUM examination on 6 July 2007, 7 months prior to separation, noted complaints of left elbow and forearm pain.  She reported difficulty grasping objects tightly and lifting greater than 15-20 pounds due to pain.  Physical examination showed a healed surgical incision.  Range of motion demonstrated 5 degrees of elbow hyperextension, 145 degrees of elbow flexion (normal), and full supination and pronation of the forearm.  There was normal elbow, forearm, and hand strength.  The neurologic examination was normal with no evidence of atrophy of the hand muscles or skin changes.  The VA Compensation and Pension evaluation on record was outside the PDBR 12 month timeframe for review.  

The Board directed attention to its rating recommendation based on the above evidence. The PEB rated the chronic left elbow and forearm pain condition 10%, coded 8716 (mild neuralgia ulnar nerve.  The Board noted normal elbow, forearm and arm strength and range of motion.  Board members agreed that the evidence did not support a 20% rating for moderate incomplete ulnar nerve neuralgia.  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 elbow and forearm pain condition.  

BOARD FINDINGS:  In the matter of the left elbow and forearm condition and IAW VASRD §4.124a, 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 20150131, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MR
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-00129.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXXXXXXXX
Principal Deputy Assistant Secretary 
(Manpower and Reserve Affairs)

Attachment:
Record of Proceedings