RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04544
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20080404

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

CI CONTENTION:  “An injury sustained in the Line of Duty rendered me unfit to finish a desirable career in service to my country and results in permanent chronic pain and limited mobility.”  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 - 20080116	VARD - 20081222	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Wrist Pain	5099-5003	10%	Right Wrist Condition	5215	0%	20080626	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Right Wrist Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right wrist condition began in August 2005 after attempting to remove an aircraft fill tank that was half-full.  The MRI revealed no evidence of fracture or other osseous abnormality and the ligaments appeared intact.  The 10 May 2007 MEB NARSUM examination, 11 months prior to separation, noted complaints of chronic pain with twisting and turning wrenches and tools.  Physical examination of the right wrist showed tenderness.  There was no swelling, deformity or discoloration.  There was good finger apposition.  Active range of motion (ROM) of the right wrist was full and testing for carpal tunnel syndrome was negative.  

At the 26 June 2008 VA Compensation and Pension (C&P) evaluation, 2 months after separation, there was no claim of weakness, fatigability, decreased endurance, incoordination or flare-ups.  Physical examination showed no tenderness, swelling or deformities.  ROM was dorsiflexion of 80 degrees (normal 70), palmar flexion of 60 degrees (normal 80), radial deviation of 20 degrees (normal) and ulnar deviation of 40 degrees (normal 45).  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right wrist condition 10%, analogously coded 5003 (arthritis, degenerative).  The VA rated the right wrist condition 0%, coded 5215, (wrist, limitation of motion of), based on the C&P examination, citing no tenderness, swelling or deformities and normal ROM tests.  

The panel agreed there was no limitation of motion that supported a rating under the VASRD diagnostic code for limitation of motion (5215).  However there was evidence of functional loss supporting the 10% rating (based on §4.59, §4.40 and §4.45) as adjudicated by the PEB.  The panel considered alternative VASRD wrist and analogous codes, but all were less applicable and/or not advantageous to rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that 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 20170506, w/atchs  
Exhibit B.  Service Treatment Record  
Exhibit C.  Department of Veterans Affairs Treatment 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-2017-04544.

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