RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02694
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20051101

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Aerospace Maintenance Journeyman, medically separated for “right wrist pain” with a disability rating of 10%.  

CI CONTENTION:  The CI made no specific contention.  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 - 20050912	VARD - 20060629	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Wrist Pain	5299-5215	10%	Residuals, Status Post-Operative Triangular Fibrocartilage Tear, Right Wrist	5019	10%	20060119	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Wrist Pain.  According to the service treatment record and MEB narrative summary (NARSUM), this right hand dominant CI underwent surgery to repair a right wrist cartilage tear in June 2004, but continued to be symptomatic post-surgery.  The 22 June 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of pain on the ulnar side of the wrist with occasional popping and catching.  She also noted numbness along the fourth and fifth digits of the right hand with activity.  Normal duties exacerbated her condition.  Physical examination showed absence of tenderness from the shoulders to the fingers, with the exception of tenderness on the ulnar side of the wrist at the ulnocarpal joint.  Motor strength was normal in the shoulder, elbow, wrist and digits.  There was no atrophy and sensation was intact to light touch.  She had full range of motion (ROM) in the right shoulder, elbow, wrist and digits with pain on motion.  There was no evidence of nerve entrapment.

At the 19 January 2006 VA Compensation and Pension (C&P) evaluation, 2 months after separation, the CI reported right wrist pain and flare-ups with any strenuous use of the wrist.  Physical examination showed absence of edema, effusion, instability, weakness and tenderness.  ROM testing of the right wrist recorded dorsiflexion of 60 degrees (normal 70) and palmar flexion of 20 degrees (normal 80).  Pain was present with motion, but repetitive motion did not cause any additional ROM loss.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right wrist condition 10%, analogously coded 5299-5215 (wrist, limitation of motion of), citing full ROM and normal motor strength of the wrist and fingers.  The VA rated the right wrist condition 10%, coded 5019 (bursitis), based on the C&P examination, citing painful or limited motion of a major joint.

Panel members agreed a 10% rating but no higher was justified for limitation of motion and painful motion.  No higher rating was achievable under any applicable code for ROM, or under the 5003 code.  The panel also noted a higher rating was not achievable under any of the muscle or nerve codes since motor strength was normal and atrophy was not present.  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 20170320, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-02694.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						Sincerely,

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings