RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-05228
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20090824

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Intelligence Analyst, medically separated for “cubital tunnel syndrome affecting…left hand” with a disability rating of 20%.

CI CONTENTION: Review of all conditions requested. 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 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 - 20090608	VARD - 20100407	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Cubital Tunnel…L Hand	8799-8716	20%	Carpal…Cubital…Left, Minor	8512	20%	20091102	
Right…Carpal Tunnel…	

Not Unfitting	Carpal Tunnel, Right, Major	8599-8515	10%		
Asthma		Asthma	6602	0%	20091026	
Allergic Rhinitis		No VA Placement	
…Lumbar Strain		Lumbar Strain	5237	10%	
20091102	
Right Heel Pain		R Heel Calcaneal Dysfunction	5299-5276	10%		
Right Knee Pain		Right Knee Pain	5260	NSC		
GERD		GERD	7399-7346	0%	
20091026	
Atopic Dermatitis		Atopic Dermatitis	7899-7806	NSC		
Syncope		Syncope, Pre-syncope	8199-8108	NSC		
Pre-syncope						
Headaches		Headaches	8100	10%		
Adjustment d/o…		Adjustment d/o…	9440	10%	20091210	
IBS		IBS	7325	0%	20091026	
R Breast Mass		Right Breast Mass	7529	NSC		
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 60%	

ANALYSIS SUMMARY:

Cubital Tunnel Syndrome…Left Hand. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s non-dominant left hand condition began approximately 3 months after having carpal tunnel release (median nerve) surgery in September 2007. Electro- diagnostic (EDX) studies revealed a left-sided neuropathy of the ulnar nerve. The CI underwent an ulnar nerve transposition surgery in May 2008. Repeat EDX studies were normal. Despite surgical intervention and rehabilitation, the CI continued to have altered sensation in the left

hand. The 6 March 2009 MEB NARSUM examination, 6 months prior to separation, noted complaints of pain and constant numbness over the little finger side of both wrist and into the third and fifth fingers. Her physical examination (PE) revealed normal range of motion (ROM) as well as weakness of the left wrist. The provider noted, “I would anticipate this [CI] accomplishing all basic daily activities without limitations and minor modifications or exertional activities.” At the 2 November 2009 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported numbness in her left small and ring fingers. Her physical examination revealed decreased radial deviation of the left wrist to 10 degrees (normal 20). All other directional ROMs were normal.

The panel directed attention to its rating recommendation based on the above evidence. Although using different VASRD codes, both the PEB and VA rated the left hand cubital tunnel syndrome at 20%, citing functional loss and current physical evaluation, respectively. The PEB used analogous code 8799-8716 (neuralgia; ulnar nerve) while the VA coded 8512 (incomplete paralysis of the lower radicular peripheral nerve group). Panel members first agreed that the PEB’s chosen primary code of 8716 was most appropriate in light of an initial definitive EDX study indicating a peripheral neuropathy. Additionally, all panel members further agreed that the severity of the CI’s sensory deficits in ulnar-related digits would support no greater impairment rating level than the PEB’s current 20%. Therefore, 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’s adjudication for the left cubital tunnel syndrome.

Contended PEB Conditions: Right (dominant) Carpal Tunnel Syndrome, Asthma, Allergic Rhinitis, Recurrent Lumbar Strain, Right Heel Pain, Right Knee Pain, GERD, Atopic Dermatitis, Syncope, Pre-Syncope, Headaches, Adjustment Disorder with Anxiety, IBS, Right Breast Mass. The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting. None of the conditions were profiled or implicated in the commander’s statement, and none failed retention standards. There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at or near separation. After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB’s fitness determination for any of the contended conditions, so no additional disability ratings are recommended.

BOARD FINDINGS: In the matter of the left cubital tunnel syndrome and IAW VASRD §4.124a, the panel recommends no change in the PEB adjudication. In the matter of the multiple contended conditions, the panel recommends no change from the PEB determinations as not unfitting. 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-2017-05228

ARXXXXXXXXXX

Dear XXXXXXXXXXXX:

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.