RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01679
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051215

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a Reserve E2, Military Policeman, medically separated for “fracture dislocation right distal radius” with a disability rating of 10%. 

CI CONTENTION:  No specific contention made.  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 - 20051116	VARD - 20060906	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Fracture Dislocation Right Distal Radius 	5215	10%	Residual, Right Wrist Fracture 	5215	10%	20060511	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Fracture Dislocation Right Distal Radius.  According to the service treatment record and MEB narrative summary (NARSUM), the right hand dominant CI suffered a fracture dislocation in July 2005 of his right distal radius, which required open reduction and internal fixation.  He was placed in a protective cast, which resulted in the wrist becoming quite stiff.  Post-surgical X-rays showed diffuse osteopenia.  Despite extensive physical rehabilitation, there was no resolution to the significant decreased range of motion (ROM) and pain.  

The 7 October 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of decreased ROM of the right wrist with pain.  Physical examination showed the ability to extend his wrist approximately 5 degrees (normal 70) from neutral and the inability to palmar flex his wrist (normal 80).  He was also unable to side bend left (radial deviation, normal 20) or right (ulnar deviation, normal 45).  

At the 11 May 2006 VA Compensation and Pension (C&P) evaluation, 5 months after separation, the CI reported intermittent 3/10 right wrist pain with stiffness.  The ROM study showed right wrist palmar flexion of 65 degrees, dorsiflexion (extension) of 70 degrees, radial deviation of 20 degrees and ulnar deviation of 45 degrees.  There was no evidence of pain, fatigue, weakness or lack of endurance, and no limitation of motion except palmar flexion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right wrist condition 10%, coded 5215 (wrist, limitation of motion), citing limitation of motion.  The VA also rated the right wrist condition 10%, coded 5215, based on the C&P examination, citing functional loss due to painful motion.  The panel noted the disparity between the limited NARSUM and the more detailed C&P examinations.  The C&P examination was more detailed and the panel concluded closer to the true final disability due to the right wrist fracture and was deemed of greater probative value.  There was no ankylosis or limitation of motion which supported a rating under the diagnostic codes for limitation of wrist dorsiflexion or palmar flexion (5214, 5215).  However, there was evidence of painful motion with functional loss supporting a 10% rating for the right wrist (§4.59, §4.40 and §4.45) based on the C&P 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 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 20170217, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180008160 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