RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01148
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20060714

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Basic Airman, medically separated for “subjective bilateral arm pain and parasthesias…”, with a disability rating of 0%.

CI CONTENTION:  The CI requested review of 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 - 20060705	VARD - 20071004	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Subjective Bilateral Arm Pain and Parasthesias…	8799-8714	0%	Subjective Bilateral Upper Extremity and Shoulder Pain
and Numbness	8599-8519	NSC	20070614 	
		0%					
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS: NSC	

ANALYSIS SUMMARY:  

Subjective Bilateral Arm Pain and Parasthesias.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral arm pain and paresthesia condition began in March 2006 with no specific trauma or injury while in Basic Training.  The condition was treated with medication with some benefit, but she required an extensive period of physical therapy/rehabilitation to achieve complete recovery.  Therefore, the CI was referred to the MEB.  The MEB forwarded “subjective upper extremity paresthesias with normal evaluation” for PEB adjudication.  

The MEB NARSUM examination, dated 19 April 2006, performed by orthopedic physician on 29 March 2006, 3 months prior to separation, noted complaints of pain in upper back and shoulder blade region with right sided radiculopathy.  The NARSUM referenced the orthopedic physical examination that showed normal appearing shoulders, tenderness on palpation of the shoulders, normal motion of the shoulders, no instability or weakness of shoulders.  Shoulder pain was elicited throughout the range of motion.  Neurological examination demonstrated no dysfunction, and muscle tone was normal.  The CI reported decreased sensation to light touch in all dermatomes of bilateral upper extremities.  The examiner diagnosed thoracic outlet syndrome and mild scoliosis.  

In May 2006, 2 months prior to separation, the CI underwent nerve conduction studies that showed no evidence of a focal neuropathy, polyneuropathy or brachial plexopathy of either arm.  The studies were normal.  Neurological consultation to the MEB conducted in May 2006 showed no evidence of neurological compromise.

At the 14 June and 18 August 2007 VA Compensation and Pension (C&P) evaluations, performed 11 months and 13 months after separation, the CI reported her shoulders continued to pain her particularly during activity.  She worked full-time.  Physical exam showed normal ROM bilaterally (180 degrees), and normal muscle strength.  There was no evidence of instability, and pain on motion was not appreciated…    

The panel directed attention to its rating recommendation based on the above evidence. 

The PEB rated each arm at 0%, for the bilateral arm pain and parasthesias condition, using an analogous 8799-8714 code (neuralgia of the musculospiral nerve (radial nerve)).  The VA denied the CI’s claim for service connection of the bilateral arm pain and parasthesias condition, citing subjective bilateral upper extremity and shoulder pain with numbness is not considered an actually disabling condition.  

The panel noted the condition was not compensable under codes 5003 (arthritis), or 5201 (ROM), and there was no evidence to support a compensable rating using VASRD §4.59 (painful motion) since radiographic evidence of joint pathology was absent.  Hence, no alternative shoulder code is supported in justification of a compensable rating under any applicable code.  There was no evidence of ratable peripheral nerve impairment which would provide for higher rating.  

After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the bilateral arm pain and parasthesias condition.  

BOARD FINDINGS:  In the matter of the bilateral arm pain and parasthesias condition and IAW VASRD §4.124a, the panel 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 20150609, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-01148.

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,

Attachment:
Record of Proceedings