RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-05234 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20070710

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Motor Transport Operator, medically separated for “left (dominant) cubital tunnel syndrome” with a disability rating of 10%.

CI CONTENTION: No specific contention was made. 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 - 20070417	VARD - 20071011	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left (Dominant) Cubital Tunnel Syndrome	8799-
8716	10%	Cubital Tunnel Syndrome, S/P Left Ulnar Nerve Transposition with Persistent Ulnar Neuropathy	8599-8515	10%	20070208	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Left (Dominant) Cubital Tunnel Syndrome. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left cubital tunnel syndrome began in February 2006 after he noted pain and numbness in his left hand and elbow. Electro-diagnostic studies confirmed the presence of a left ulnar neuropathy. In October 2006, he underwent a surgical transposition of the left ulnar nerve at the elbow. Despite post-surgical improvement in distal strength and grip, pain along the left ulnar nerve path continued.

At the 8 February 2007 VA Compensation and Pension (C&P) examination, 5 months before separation, the CI reported persistent and constant pain about the left elbow which was aggravated by weather changes or exercise. The physical examination (PE) revealed normal range of motion (ROM) of the left elbow. No local tenderness was present and muscle strength of the left arm was normal.

Eight days later, the MEB NARSUM examination listed the CI’s chief complaint as “left dominant elbow pain and numbness.” The focused PE revealed decreased ROM of the left elbow noting extension to 5 degrees (normal 0) and flexion to 130 degrees (normal 145). His pain was assessed as being frequent and of slight intensity.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left cubital tunnel syndrome 10%, analogously coded 8716 (ulnar nerve neuralgia), citing rated as mild, incomplete paralysis. The VA also rated the left cubital tunnel syndrome 10%, analogously coded 8515 (median nerve, paralysis), based on the C&P examination, citing mild incomplete paralysis of hand movements. Panel members first agreed that absent any severe degree of limited joint motion, the PEB’s chosen primary code of 8716 was most appropriate in this case by having an identified ulnar neuropathic condition noted in an electro- diagnostic study. Additionally, all panel members further agreed that given the absence of local tenderness, the maintenance of normal muscle strength and pain assessed as slight, would support a rating no greater than “mild” impairment at 10%. 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 condition.

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. 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-2017-05234

ARXXXXXXXXXXX

Dear XXXXXXXXXXXXXX:

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.

Sincerely,

Enclosure