RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-03946
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20090202

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty, Hull Maintenance Technician, medically separated for “carpal tunnel syndrome [CTS], bilateral,” rated 10% for each wrist, with a combined disability rating of 20%.

CI CONTENTION: Review requested of CTS as well as an additional condition not identified by the Physical Evaluation Board (PEB) or Medical Evaluation Board (MEB). 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 - 20080919	VARD - 20090508	
Condition	Code	Rating	Condition	Code	Rating	Exam	
CTS, Bilateral	8615	10%	CTS, Right Wrist	8515	0%	20081126	
	8615	10%	CTS, Left Wrist	8515	0%	20081126	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Bilateral CTS. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent a right carpal tunnel release in May 2007 and a left carpal tunnel release in June 2007. There was near complete resolution of altered sensation in both hands, but he still had hand weakness and occasional pain greater on the right than left.

At the 21 July 2008 MEB NARSUM examination, 6 months prior to separation, the examiner noted very mild motor weakness of the radial, median and ulnar nerves (assessed as “near normal) with no evidence of tenderness or edema in either wrist. Upper extremity circulation and sensation were normal, but after wrist flexion testing (Phalen), middle and ring finger numbness and tingling occurred bilaterally.

During the 26 November 2008 VA Compensation and Pension (C&P) examination, 2 months prior to separation, the CI reported numbness, tingling and weakness in his fingertips, and functional impairment with strenuous work or typing. Physical examination revealed painful and slightly decreased bilateral wrist range of motion, but normal strength.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right and left wrist conditions 10% each, coded 8615 (neuritis of the median nerve). The VA rated the right and left wrist conditions 0% each, coded 8515 (paralysis of the median nerve), based on the C&P examination, citing a noncompensable evaluation due to CTS with release and weakness with decreased movement and pain in left and right wrists. Panel members noted that athough the NARSUM examiner mentioned three peripheral nerves were likely involved in the CTS, the Phalen’s test specifically corresponded to the median nerve distribution (middle and ring fingers). Code 8615 is based on the severity of symptoms, and the panel adjudged that CI’s post-surgical symptoms of altered sensation and or pain in two fingertips of both hands was of no greater intensity than mild for a 10% rating. 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 and left wrist conditions.

BOARD FINDINGS: In the matter of the bilateral wrist 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-2017-03946

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 20May20

From: 

Director, Secretary of the Navy Council of Review Boards 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW  (PDBR)

Ref:	(a) DoDI 6040.44
(b) PDBR ltr <ltd 25 Jul 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate  action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no 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.