RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXX	CASE: PD-2017-02228
BRANCH OF SERVICE:  NAVY	SEPARATION DATE: 20051226

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Aegis Console Operator, medically separated for “right musculocutaneous nerve branch axonal neuropathy” with a disability rating of 10%.

CI CONTENTION: In addition to the nerve condition, the CI requested review of an additional condition not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB). 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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20050922	VARD – NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Musculocutaneous Nerve Branch Axonal Neuropathy	8617-8717	10%	
No VA Examination Proximate to Separation in Evidence	
Persistent Exertional Pain	Cat II		
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Right Musculocutaneous Nerve Branch Axonal Neuropathy. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right upper extremity nerve condition began in August 2004 after performing pushups. Electrodiagnostic studies (EMG/NCV) showed severe axonal injury to the motor branch of the musculocutaneous nerve with no evidence of re- innervation. There was no evidence of right median, ulnar, superficial radial or lateral

antebrachial cutaneous neuropathy, right brachial plexopathy (upper or middle trunk) or right cervical radiculopathy. The CI was placed on an 8 month LIMDU. Repeat EMG/NCV performed in March 2005 showed a predominantly musculocutaneous neuropathy with evidence of re- innervation.

At the 9 August 2005 MEB NARSUM examination, 5 months prior to separation, the CI reported gradual improvement in the right upper extremity symptoms and similar but less severe symptoms in the left upper extremity. He could do light running, but not many push-ups before pain was provoked. Physical examination showed normal strength and muscle tone in all extremities. Upper extremity sensation and reflexes were normal. There was no evidence of impaired coordination. 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 right upper extremity nerve condition 10%, dual coded 8617-8717 (musculocutaneous nerve neuritis and neuralgia). The PEB’s Category II diagnosis of persistent exertional pain is intrinsic to the rated condition and a separate rating cannot be supported without pyramiding (VASRD §4.14); thus, it is appropriately subsumed under the same rating.

The panel agreed that the disability due to the right upper extremity nerve condition at separation was best characterized as mild or moderate and not severe incomplete paralysis under 8517 or related codes. The MEB NARSUM examination showed normal reflexes, sensation and full strength of the right upper extremity, although function was still limited by pain with use of the arm. VASRD §4.124a rating guidance states that “when the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree.” Additionally, VASRD §4.124 (neuralgia 8617) and §4.123 (neuritis) state that neuralgia or neuritis without organic changes such as muscle atrophy or loss of reflexes should be rated with a maximum equal to the moderate degree. 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 musculocutaneous nerve condition.

BOARD FINDINGS: In the matter of the right musculocutaneous nerve condition and IAW VASRD
§4.124a, 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.

2	PD-2017-02228

DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO,
1850
CORB: 003
10 Sep 20

From: Director, Secretary of the Navy Council of Review Boards To:	XXXXXXXXXXX

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.