RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-05154
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20070703

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Computer Systems Operations Journeyman, medically separated for “complex regional pain syndrome” with a disability rating of 20%.  

CI CONTENTION:  “Complex Regional Pain Syndrome (CRPS) Left Wrist, injury to left wrist, and multiple surgeries.”  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 - 20070517	VARD - 20080808	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Arm CRPS	8715	20%	Chronic Pain Syndrome (Arthritis)	5003	NSC	N/A	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  NSC	

ANALYSIS SUMMARY:  

Left Arm CRPS.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the right-hand dominant CI’s left wrist/arm condition) began in 2000 when he was diagnosed with a neuroma (nerve tumor) of the left median nerve that had grown over an area of previous trauma.  Despite multiple treatment modalities to include surgical removal of the tumor as well as implanting a peripheral nerve stimulator, the CI’s arm pain continued.  The 9 April 2007 MEB NARSUM examination, 3 months prior to separation, noted complaints of continued left arm pain.  The physical examination (PE) revealed full range of motion (ROM) of both upper extremities.  Strength and sensation of the upper extremities were normal.  The scars were “mildly tender.”  The provider additionally commented, “[The CI] states he is still capable to fulfill the requirements of his job.”  The CI failed to attend the scheduled VA Compensation and Pension (C&P) examination on 6 June 2008, 11 months after separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the CRPS condition 20%, coded 8715 (neuralgia; median nerve), citing general DoD and VASRD guidelines.  The VA did not service connect the condition based on the fact that the CI did not attend the examination and the VA stated that it could not obtain STRs that would allow them to rate the condition.   After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel agreed that a nerve rating best described the CI’s condition and that the PEB’s code of 8715 specifically and correctly identified the affected “median nerve.”  In regards to a rating impairment, panel members additionally agreed that given the CI’s ability to continue to perform his job duties as noted in the NARSUM, a rating greater than “moderate” (20%) was not supported.  Therefore, the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the left arm condition.

BOARD FINDINGS:  In the matter of the complex regional pain syndrome 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.  

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05154.

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.