DEPARTMENT OF THE AIR FORCE
WASHINGTON DC

Office of the Assistant Secretary

SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435
MEMORANDUM FOR THE ASSISTANT SECRETARY OF THE NAVY, MANPOWER AND RESERVE AFFAIRS

SUBJECT: Physical Disability Board of Review Recommendation on XXXXXXXXXX Case Number PD-2017-03638

In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual (CI) from the United States Marine Corps. After carefully reviewing the application and medical separation case file, the PDBR recommended no re- characterization of the separation or modification of the disability rating previously assigned. I recommend you accept this proposed decision.

The CI was an active duty E4, Mortarman, medically separated for “crush injury dominant right hand” and “cognitive disorder,” rated 10% each, with a combined disability rating of 20%. The PEB rated the right hand condition 10%, coded 5307 (Group VII forearm and hand muscles). The VA rated the condition 10%, dual coded 5024-5215 (tenosynovitis- limitation of motion of the wrist). A 30% rating (right hand dominant) under code 5307 requires demonstration of impairment to the moderately severe level, but the Compensation and Pension (C&P) examination, 3 months before separation, showed near full wrist and finger range of motion (ROM), with the exception of the thumb, which demonstrated near full ROM in all planes but interphalangeal flexion, which was reduced 50%. Hand grip and muscle strength was good with no evidence of atrophy, and the CI was able to use both hands for grasping, pushing, pulling, writing, buttoning clothing and picking up small objects. Thus, a 10% rating and no higher, was justified for moderate impairment. Other VASRD hand/finger and analogous codes were considered, but all were less applicable and/or not advantageous for rating.

The PEB rated the cognitive disorder 10%, dual coded 8045-9304 (residuals of traumatic brain injury-dementia due to head trauma). The VA rated the condition 30%, dual coded 8045- 9432 (residuals of traumatic brain injury-bipolar disorder), based on the C&P examination, citing occupational and social impairment, depressed mood, sleep impairment and anxiety. The VARSD in effect at the time of separation captured brain injuries under the generic category of brain disease due to trauma, coded 8045. There are two different scenarios for rating under this code: analogously with purely neurological deficits, or based on purely subjective symptoms. In the absence of associated neurological disabilities (seizures, nerve paralysis, etc.), rating this condition under 8045-9304 was limited to 10%, and could not be combined with any other rating for a disability due to brain trauma. Rating under VASRD 4.130 using code 9304 was also considered, but the MEB neuropsychological examination (closest to separation and carried

highest probative value) noted the CI did not require any mental health (MH) treatment for coping skills and there was not diagnosis of a primary anxiety or mood condition. The mental status examination was essentially normal, with reports of feeling down and frustrated with a mildly blunted affect. Thus, there was minimal evidence of occupational or social impairment due to primary MH symptoms, including symptoms related to memory or concentration problems, and thus a rating under VASRD 4.130 was of no benefit to the CI, since a rating higher than the 10% was not justified.

The panel also assessed the fairness of the PEB determination that the contended low back/pelvic rim pain and ruptured spleen and left kidney were not unfitting. None of the conditions were implicated in the non-medical assessment and did not fail retention standards. There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation. 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 hand condition and cognitive disorder; or for the PEB fitness determination for any of the contended conditions, so no additional disability ratings are recommended.

2	PD-2017-03638

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:	 

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.