RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01697
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081112

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Trainee, medically separated for “chronic right (dominant) wrist pain,” with a disability rating of 10%.

CI CONTENTION:  The CI requested consideration of all conditions. The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(s) at the time of separation.  The panel 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 panel 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 - 20081007	VARD - None	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right (Dominant) Wrist Pain…	5099-5003	10%	No VA Exam in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:  

Chronic Right (Dominant) Wrist Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI injured his right wrist in February 2008 during pugil stick training.  He was found to have a fracture of the distal radius (long forearm bone on the side of the thumb) and a separation of two bones in the wrist.  These were repaired surgically on 5 March 2008 and he entered rehabilitation.  Despite this, he reported ongoing pain and the inability to return to the activities of basic training.  The MEB NARSUM examination was dated 6 August 2008, 3 months prior to separation.  The CI reported the ongoing difficulties with his dominant right wrist.  On examination, he was able to dress and undress easily and got on and off the examination table without evident discomfort.  The scar was tender but well healed.  A ‘popping’ sensation was present with repetitive motion.  ROM after repetition was palmar flexion 71 degrees (normal 80), dorsiflexion 47 (normal 70), ulnar deviation 23 (normal 45), and radial deviation 14 (normal 20).  There was pain in all planes of motion.  An X-ray showed that the radial fracture was well-healed, but that there was persistent widening of the scapholunate joint (the affected wrist bones).  Grip strength was 4/5.  He was thought to be stable, but future evaluation was anticipated.  There was not a VA Compensation and Pension (C&P) evaluation proximate to separation in evidence.  The range of motion examinations in evidence which the panel weighed in arriving at its rating recommendation, with documentation of additional ratable criteria, are summarized below. 

Right/Left Wrist ROM
(Degrees)	MEB ~3 Mo. Pre-Sep	
Dorsiflexion (70 Normal)	42/61/47//64/67/65	
Palmar Flexion (80)	67/76/71//71/73/72	
Ulnar Deviation (45)	17/34/23//35/36/35	
Radial Deviation (20)	12/17/14//18/19/18	
Comment	Painful motion.  Grip 4/5	
§4.71a Rating	10%	

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right wrist pain condition 10%, coded 5099-5003 (degenerative arthritis), citing painful motion.  The panel considered the evidence.  The limitation in motion was not compensable under code 5215 (wrist limitation in motion).  A 10% rating for painful and limited motion is supported under the code 5003.  No route to a higher rating was found.  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 chronic right wrist pain condition.  

BOARD FINDINGS:  In the matter of the chronic right wrist pain condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150628, w/atchs
Exhibit B.  Service Treatment Record

AR20170008717, XXXXXXXXXXXXXXXXXX

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Dear XXXXXXXXXXXXXXXXXX

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,