RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-04426
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050508

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E-3, Infantryman, medically separated for “persistent right (dominant) arm pain” with a disability rating of 10%.  

CI CONTENTION:  The VA rating was higher.  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 - 20050405	VARD - 20050620	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Persistent Right  Arm Pain	5305	10%	Residual of Decreased Strength and Loss of Muscle Substance with Right Arm Pain 	5305
 	10%
 	20050315
 	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Persistent Right (Dominant) Arm Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent surgery on 1 July 2004 for primary repair of the biceps brachii (muscle) after injuring his right arm in a static line airborne jump.   

During the 28 January 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported loss of range of motion (ROM) and strength, as well as pain since surgery.  The upper extremities evaluation was marked normal. 

The 17 February 2005 MEB NARSUM examination, 3 months prior to separation, noted complaints of right arm pain with even light activities.  Physical examination showed an obvious concavity at the mid-point of the incision with an obvious failure of the medial head of the biceps repair.  There was essentially no significant tenderness.  The elbow, shoulder and wrist had full, unrestricted ROM without pain, and there was no axillary or musculocutaneous nerve, motor or sensory deficits.  

At the 15 March 2005 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported right arm biceps pain and weakness, loss of strength, easy fatigability and could not keep up with work requirements because of difficulty lifting over 40 pounds.  Physical examination showed a non-tender scar over the anterior right upper arm without adherence of underlying structures or bone and without intermuscular scarring.  There was no muscle herniation, or any tendon, bone, joint or nerve damage.  There was palpable loss of muscle substance and decreased (4/5) right upper arm strength.  The ROM of both shoulders and elbows were symmetrically equal and measured to the VASRD normal limits without any additionally limitations by pain, fatigue, weakness, lack of endurance or incoordination after repetitive use.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right arm condition 10%, coded 5305 (muscle group V function), citing moderate muscle disability.  The VA rated the right arm condition 10%, coded 5305, citing moderate muscle disability.  VASRD §4.56 (evaluation of muscle disabilities) provides classification guidance for muscle injuries.  Examinations proximate to separation showed no evidence of a through and through or deep penetrating wound; debridement; prolonged infection or sloughing; intermuscular scaring; prolonged hospitalization; or other sufficient evidence to more closely approach a moderately severe muscle disability for the next higher rating under code 5305.  There was no shoulder or elbow joint limitation of motion or objective evidence of painful motion, for rating under those joint codes.  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 arm condition.  

BOARD FINDINGS:  In the matter of the right arm condition and IAW VASRD §4.73, 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:

[AR Number], XXXXXXXXXX

Dear XXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.