RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00580
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20050615

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Basic Marine, medically separated for “left forearm mid shaft radius and ulna fractures,” with a disability rating of 10%.  

CI CONTENTION:  The CI requests the Board consider all conditions.  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 on 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 - 20050414	VARD - 20051017	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Forearm Mid Shaft Radius and Ulna Fractures	5099-5003	10%	Status Post Open Reduction Internal Fixation Left Radius and Ulna	5213	10%	20050427	
			Residual Scars, Left Forearm	7805	0%	20050427	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Left Forearm.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the right-handed CI sustained an open fracture of the left radius and ulna (forearm bones) in January 2005 during boot camp training.  Following surgery (open reduction and internal fixation - ORIF) further treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “other postsurgical status” for PEB adjudication.  

The MEB NARSUM examination on 15 March 2005, 3 months prior to separation, indicated the CI was 2 months status post left forearm ORIF, with no complaints of pain.  Physical examination showed well healed forearm scars.  The left elbow range of motion (ROM) was 0-135 degrees flexion (normal 0-145), with forearm pronation to 45 degrees (normal 80) and supination to 90 degrees (normal 85).  Left pronation ROM was the only measurement less than the unaffected right arm measurements.  Motor strength, sensation and vascular testing was all normal.  X-rays showed left forearm mid shaft fractures of ulna and radius well-healed with good alignment and intact hardware.  

At the 27 April 2005 VA Compensation and Pension (C&P) evaluation, performed 2 months before separation, the CI reported a left forearm compound fracture treated by ORIF.  Physical examination showed well healed, non-tender, surgical scars of the left forearm.  The forearm was not deformed or tender to palpation.  Left elbow ROM was 0-140 degrees (normal 0-145), with forearm pronation to 66 degrees (normal 80) and supination to 90 degrees (normal 85).  Wrist motion was dorsiflexion to 51 degrees (normal 70) and palmar flexion to 73 degrees (normal 80).  There was no painful motion and no additional loss of motion on repetition.  Strength was normal with normal sensation to light touch and decreased pinprick sensation to 3/5 (normal 5/5) over the left ulnar nerve.  The diagnosis was compound fracture of the left radius and ulna, status post ORIF with uncomplicated healing, confirmed on X-rays.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left forearm condition 10%, coded analogously to 5003 (arthritis degenerative).  The VA rated the left forearm condition 10% coded 5213 (supination and pronation, impairment of), based on the VA C&P examination 2 months after separation, citing slight limitation of motion of the left elbow on pronation without pain.  There was no ratable limitation of elbow, forearm or wrist ROM, and no non-union, malunion, or bad alignment of the radius or ulna to warrant any rating higher than 10%.  No additional functional limitation was evidenced by the examinations.  There was not a ratable peripheral nerve disability.  Therefore the Board concluded there was not sufficient evidence to support a rating higher than the 10% adjudicated by the PEB.  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 forearm condition.  

BOARD FINDINGS:  In the matter of the left forearm 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 20150603, with attachments
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 16 Nov 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:

		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC

						  XXXXXXXXXXXXXXXXXX
	     				  	  Assistant General Counsel
						  (Manpower & Reserve Affairs)