RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01042
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20051006

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Petroleum Supply Specialist, medically separated for “chronic pain, left wrist, status post (S/P) operative fixation of scaphoid fracture” with a disability rating of 10%.  

CI CONTENTION:  The CI submitted a lengthy contention for his left wrist condition.  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 - 20050808	VARD - 20051102	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain Left Wrist…	5099-5003	10%	S/P ORIF of Left Wrist…	5099-5010	10%	20050825	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Chronic Pain Left Wrist.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the right hand dominant CI fractured his left wrist during combative training on 3 December 2004.  He was placed in a cast, but had persistent pain.   On 21 February 2005 the CI underwent an open reduction and internal fixation (ORIF) of the scaphoid (a wrist bone).  Following surgery, he was not able to return to full duties.

During the MEB examination (recorded on DD Forms 2807-1 and 2808) dated 20 June 2005, 4 months prior to separation, the CI reported left wrist impaired use and pain.  The range of motion (ROM) of the wrist was noted to be reduced.  The 14 July 2005 MEB NARSUM examination, 3 months prior to separation, the CI reported chronic left wrist pain despite evidence of healing on X-rays.  ROM showed flexion (palmar) 20 degrees (normal 80) and extension (dorsiflexion) 50 degrees (normal 70).  Radial and ulnar deviation were 7 and 20 degrees, respectively (20 and 45 normal).  The right hand grip was 140 pounds and the left was 84 pounds.  X-ray studies showed a good repair.  

At the VA Compensation and Pension (C&P) examination performed on 25 August 2005, 11 months after separation, the CI reported continued pain.  The physical examination showed swelling on the left wrist.  Palmar flexion was 65 degrees, dorsiflexion 55 degrees, and radial and ulnar deviation were 10 and 35 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic pain in the left wrist condition 10%, coded 5099-5003 (analogous to degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA also rated the left wrist condition 10%, coded 5099-5010 (analogous to traumatic arthritis), based on the C&P examination 11 months after separation, citing painful and limited motion.  The panel considered the evidence.  The limitation in motion was not compensable under the code 5215 (limitation in motion of the wrist).  The painful, limited motion with X-rays evidence of pathology supported the 10% rating adjudicated by both the PEB and VA.  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 there was insufficient cause to recommend a change in the PEB adjudication for the chronic pain in the left wrist condition.  

BOARD FINDINGS:  In the matter of the chronic pain in the left wrist 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. 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 20170306, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20180005509 , XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

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,					      
Enclosure