RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01503
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050301

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Motor Transport Operator, medically separated for “right wrist pain and limitation of motion” with a disability rating of 10%.  

CI CONTENTION:  Review of all conditions requested.  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 - 20040917	VARD - 20051130	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Wrist Pain	5003	10%	Degenerative Joint Disease of the Right Hand Status Post Old Fracture / Tendon  Injury	5010-5215	10%	20051026	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Right Wrist Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s wrist condition began in February 2003 after a motor vehicle accident.  277 June 2003 MRI studies revealed a tear of the scapholunate ligament and tendinosis involving the extensor carpi ulnaris tendon.  The 3 September 2003 diagnostic arthroscopy demonstrated post-traumatic arthritis of the distal radius, rupture of the scapholunate ligament and rupture of the posterior aspect of the triangular fibrocartilage complex.  On 20 October 2003 the CI underwent radial styloidectomy and repair of the scapholunate ligament. 

The 27 August 2004 MEB NARSUM examination, 7 months prior to separation, noted complaints of right wrist pain, loss of wrist range of motion (ROM), and decreased hand strength.  Physical examination showed palmar flexion to 30 degrees (normal 80), dorsiflexion to 40 degrees (normal 70).  Right hand strength was 60 pounds and the left was 120 pounds.  

At the 26 October 2005 VA Compensation and Pension (C&P) examination, 7 months after separation, the CI reported constant right wrist pain, loss of strength, and decreased ROM. Physical examination showed slight thenar atrophy and 4/5 right hand strength.  The ROMN was palmar flexion to 25 degrees and dorsiflexion to 10 degrees.  The examiner noted pain limitation with motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right wrist condition 10%, coded analogously using 5003 (degenerative arthritis), citing painful motion and limitation of motion.  The VA also rated the right wrist condition 10%, coded 5010-5215 (limitation of motion of wrist), based on the C&P examination, citing dorsiflexion of wrist less than 15 degrees.  The panel agreed there was painful motion and pain limitation of motion to support a 10% rating.  There was no evidence of anklyosis or radius nonunion for a higher than 10% rating.  After due deliberation, considering all 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 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 20170218, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180008976, 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