RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00824
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20091230

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Basic Marine, medically separated for “status post open reduction internal fixation [ORIF] with screw in place,” with a disability rating of 10%.

CI CONTENTION:  The CI made no specific contention.  The 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 - 20091109	No VA Claim	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Status Post ORIF with Screw in Place	5099-5003	10%	No VA Claim	
Right Wrist Scaphoid Fracture, Displaced; Healed 	Cat II		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS: --	

ANALYSIS SUMMARY:  

Status Post ORIF with Screw In Place.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s status post ORIF with screw in place condition (dominant hand) began in July 2009 as a surgical repair of a displaced fracture of the right wrist scaphoid bone.  The CI fell out of his bed.  X-rays and contrast tomography (CT) demonstrated the fracture.  He received occupational therapy post-surgery.  The MEB forwarded “closed fracture of navicular (scaphoid) bone of wrist” and “other post-surgical status” for PEB adjudication.  

The MEB NARSUM examination on 6 October 2009, 3 months prior to separation, noted the CI reported little discomfort and no sensory changes.  He complained of stiffness in the wrist but denied other symptoms.  Physical examination showed deformity of the right wrist with a well-healed surgical scar, no swelling, redness, heat or bruising.  He was neurovascularly intact.  Range of motion (ROM) showed flexion to 70 degrees (normal 70), radial deviation 25 degrees (normal 20) and ulnar deviation 30 degrees (normal 45).  There was no tenderness in the anatomic snuff box area.  There was no discomfort with weight on the thumb.  The last X-rays, dated September 23, showed a healed residual fracture line with the screw in place.  He remained in occupational therapy and a home program.  

The orthopedics examination, dated 18 November 2009, noted normal flexion of 70 degrees, ulnar deviation 35 degrees and radial deviation 20 degrees.  The CI reported he was doing well, denied pain, and had no complaints. 

The Board directed attention to its rating recommendation based on the above evidence. The PEB rated the status post ORIF with screw in place condition 10%, coded 5099-5003 (degenerative arthritis).  The PEB also listed right wrist scaphoid fracture, displaced; healed as a related Category II condition (a condition that contributed to the primary unfitting condition but was not separately ratable).  The impairment from the right wrist scaphoid fracture, displaced; healed was properly subsumed under the overall rating for the status post ORIF with screw in place IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited).  There is no record of the VA rating the right wrist condition.  Both the NARSUM examination 3 months prior to separation and the orthopedics examination a month prior to separation noted the CI had minimal discomfort, few symptoms and was doing well.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded there was insufficient cause to recommend a change in the PEB adjudication for the status post ORIF with screw in place condition.  

BOARD FINDINGS:  In the matter of the s/p ORIF with screw in place condition and IAW VASRD §4.71a, the Board 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 20150604, 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 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:

		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC

						  XXXXXXXXXXXXXXXXXXX
	     				  Assistant General Counsel
						  (Manpower & Reserve Affairs)