RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-03499
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060421

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Cannon Crewmember, medically separated for “right wrist pain” with a disability rating of 0%.  

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 - 20060223	VARD - 20070117	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Wrist Pain	5099-5003	0%	Residual of Fracture, Right Scaphoid	5215	10%	20070104	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Wrist Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI fractured his right scaphoid in November 2001.  He entered the Army in September 2004 with a waiver.  On 26 February 2005 he fell and tried to break his fall with his right hand.  A bone scan showed findings consistent with a healing/recent fracture of the right scaphoid and was considered to represent a re-fracture.  He was managed conservatively.  

The 29 November 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of a dysfunctional wrist with pain.  Physical examination showed tenderness and a small healed scar on the dorsal aspect of the radial side of the wrist.  Limitations of movement were noted in flexion and extension, with associated pain.  He had full range of supination and pronation, and motor and sensory function were intact.  Range of motion (ROM) measurements were performed by occupational therapy on 14 December 2005.  The right wrist ROM showed dorsiflexion of 45 degrees (normal 70) and palmar flexion of 60 degrees (normal 80).  

At the 4 January 2007 VA Compensation and Pension (C&P) examination, 9 months after separation, the CI reported continued pain with use.   Physical examination showed ROM measurements with 55 degrees of dorsiflexion and 80 degrees of palmar flexion with painful motion.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right wrist condition 0%, analogously coded as 5099-5003 (arthritis, degenerative), citing application of the US Army Physical Disability Agency pain policy.  The VA rated the right wrist condition 10%, coded 5215 (wrist, limitation of motion of), based on the C&P examination, citing painful or limited motion of a major joint.    

The panel agreed the condition was not compensable under any of the wrist codes (5214 for ankylosis of wrist, 5215 for limitation of motion of wrist, or the forearm code 5213 for impairment of supination and pronation).  However, panel members agreed a 10% rating is justified for painful motion and functional loss IAW VASRD §4.59 and §4.40.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right wrist condition, coded 5099 5003.  

BOARD FINDINGS:  In the matter of the right wrist condition, the panel recommends a disability rating of 10%, coded 5099-5003 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 the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Right Wrist Pain	5099-5003	10%	

AR20180015357, 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.