RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01925
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20060415

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Aviation Radar Repairer, medically separated for a “left distal humerus fracture” with a disability rating of 0%.  

CI CONTENTION:  “My actual range of motion was minimized or ignored in my original disability determination.”  The 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 - 20060208	VARD - 20070706	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Distal Humerus Fracture	5299-5202	0%	Residuals, Closed Fracture, Left Humerus Distal End 	5201	0%	20070522	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Left (Non-Dominant) Distal Humerus Fracture.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the right-handed CI’s left humerus fracture occurred on 4 September 2005 (7 months prior to separation) when he had an accident water skiing and suffered a comminuted fracture of his distal left humerus (multiple-piece, closed fracture of the upper arm bone near the elbow).  

At the 21 November 2005 physical therapy evaluation, the CI reported strength was increasing and range of motion (ROM) continued to improve each day.  The 8 December 2005 MEB NARSUM examination, 4 months prior to separation, noted “no complaints, but he continues to wear his Sarmiento fracture brace” and was receiving physical therapy (PT) for range of motion of his left elbow and wrist.  The physical examination showed no gross deformity with full ROM of the shoulder, elbow, and wrist.  X-ray studies demonstrated a healing Holstein-Lewis fracture of the distal humerus with less than 10 degrees of angulation in the coronal and sagittal planes.  The 16 December 2005 Orthopedics appointment, 3 months prior to separation, showed findings of full shoulder ROM, elbow ROM of 0-120 (0-145 normal) and wrist ROM was full.  No pain was recorded.  

During the 12 January 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported left shoulder pain.  The physical examination showed muscle atrophy of the left triceps and biceps, tenderness to palpation of the left posterior distal humerus with a hard callous felt.  The left arm was noted to be one inch shorter than the right.  

At the 22 May 2007 VA Compensation and Pension (C&P) evaluation, 13 months after separation, the CI reported a mild ache in his left arm, rated 3/10 and constant and dull in nature.  The CI reported intermittent shooting pains with certain movements and mild weakness but no stiffness or fatigability.  The physical examination showed the left arm was one inch shorter than the right arm.  There was no evidence of deformity in the distal humerus.  There was no malunion or non-union.  There was no tenderness, no edema or painful motion of the left upper extremity.  There was no evidence of joint involvement.  The ROM of the shoulder and elbow joints were normal.  The ROM of the wrist and digits in the left hand were also normal.  The handgrip was slightly less when compared to the dominant right hand.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left humerus fracture condition 0%, coded 5299-5202 (humerus, other impairment of).  The VA also rated the left humerus closed fracture residuals 0%, coded 5201, (arm, limitation of motion of), based on the C&P examination 13 months after separation, citing a noncompensable rating is assigned unless arm motion is limited at the shoulder level.  ROM of the shoulder and elbow were normal.  

There was no limitation of motion of the shoulder to support a rating under diagnostic code 5201 (arm, limitation of motion of).  There was no compensable limitation of motion of the elbow.  The NARSUM and C&P examinations did not note findings such as swelling, muscle spasm, satisfactory evidence of painful motion or other evidence of functional loss of the shoulder or elbow joints to support a 10% rating IAW VASRD §4.59, §4.40 or §4.45.  There was no malunion, deformity, or recurrent dislocation of the humerus to justify a rating under the 5202 code (humerus, other impairment of).  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 left humerus fracture condition.  

BOARD FINDINGS:  In the matter of the left humerus fracture condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150712, 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

      In accordance with reference (a), I have reviewed the cases listed below and 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 USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC

		
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	     				     Acting