RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-01746
BRANCH OF SERVICE:  Navy 	SEPARATION DATE:  20040121

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Engineman, medically separated for “right scaphoid non-union, wrist” with a disability rating of 10%.  

CI CONTENTION:  “Review all conditions.”  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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20031027	VARD - 20040412	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Scaphoid Non-Union, Wrist 	5299-5003	10%	Residual Fractured Right Navicular Bone	5215	10%	20040115	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Wrist.  According to the service treatment record and MEB narrative summary (NARSUM), the right-dominant CI’s wrist condition began prior to enlistment following a snowboarding accident, but no problems were noted during his accession physical.  The wrist became symptomatic around 27 June 2001 and X-rays showed an old non-united scaphoid (wrist bone) fracture.  The CI underwent surgery on 11 March 2002 and was referred to occupational therapy for rehabilitation.  While his wrist function improved, he was not able to return to full duty after two limited duty (LIMDU) periods.  
At a hand surgery appointment on 3 June 2003, the CI reported persistent pain and decreased range of motion (ROM) and grip strength.  Measure ROM, in degrees, was dorsiflexion to 40 (normal 70), palmar flexion to 60 (normal 80), ulnar deviation to 35 (normal 45) and radial deviation to 15 (normal 20).  Strength was reduced to 55 pounds on the right as compared to 135 on the left.  The MEB NARSUM examination was done the same day by the same hand surgeon and reiterated the above.  

At the 15 January 2004 VA Compensation and Pension (C&P) examination, 12 days prior to separation, the CI reported a 26-month history of right wrist pain and weakness.  The physical examination showed, in degrees, dorsiflexion of 10, palmar flexion of 60, ulnar deviation of 35, and radial deviation of 0; all motion was limited by pain.  The motor examination was normal and X-rays showed post-surgical changes.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right wrist condition 10%, analogously coded 5299-5003 (degenerative arthritis), after a 10% existed prior to service (EPTS) deduction.  The VA also rated the right wrist condition 10%, coded 5215 (limitation of motion of the wrist), based on the C&P examination, citing dorsiflexion of less than 15 degrees.  Members first considered whether the EPTS deduction was appropriate.  While the history supported a contention that the wrist was injured prior to service, the records do not show any difficulty with the wrist for the first year of service and the accession records were silent.  Thus, the panel found no evidence upon which to base an EPTS deduction.  Members agreed that a 10% rating is supported under code 5003 for limited and painful motion as adjudicated by the PEB, but criteria for a 20% rating, which requires the involvement of two or more major joints with incapacitation, were not met.  Members also noted that a 10% rating was supported under code 5215 for the limitation in dorsiflexion (palmer flexion was not compensable) found on the VA examination.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the right wrist condition.  

BOARD FINDINGS:  In the matter of the right wrist scaphoid non-union condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends 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 20160915, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs 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:

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

							XXXXXXXXXXXXXXXXXX
	     				                        Assistant General Counsel
						           (Manpower and Reserve Affairs)