RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-01870
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20050224

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E1, Trainee, medically separated for “chronic left elbow pain” with a disability rating of 0%.  

CI CONTENTION:  The rating should be higher.  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 - 20050215	VARD - 20050324	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Elbow Pain	5099-5003	0%	Status Post Left Elbow Dislocation	5299-5207	10%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Left Elbow Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the right-handed CI’s left elbow condition began on 2 December 2004 after dislocating his elbow during hand-to-hand combat training.  The dislocation was reduced satisfactorily and there was no evidence of fracture on radiographs.  

The 24 January 2005 MEB NARSUM examination, 1 month prior to separation, noted complaints of left elbow pain, aggravated with motion or any type of lifting.  Physical examination showed tenderness.  Range of motion (ROM) was 5-125 degrees (normal 0-145) with pain.  There was no neurovascular deficit.  There was no VA examination proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left elbow condition 0%, coded analogously 5099-5003 (degenerative arthritis), citing good return of motion from 5-125 degrees and pain with repetitive or strenuous motion, normal radiographs and minimal loss of motion.  The VA rated the left elbow condition 10%, coded analogously 5299-5207 (limitation of extension of forearm), based on the STR.  

There was no compensable limitation of elbow motion under codes 5205 thru 5213 for the left elbow.  However, the NARSUM examination noted the presence of painful motion causing functional loss (based on §4.59, §4.40 and §4.45).  A 10% rating was therefore warranted IAW VASRD §4.59 (painful motion) and DeLuca.  Rating at 10% analogous to extension or to flexion was deliberated.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the left elbow condition, coded 5299-5207.  

BOARD FINDINGS:  In the matter of the left elbow condition, the panel recommends a disability rating of 10%, coded 5299-5207 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Left Elbow Pain	5299-5207	10%	

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

AR20180005852, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,					      
Enclosure