RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-05579 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20060331

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Rifleman, medically separated for “left hand decreased function and pain” with a disability rating of 20%.

CI CONTENTION: “The VA rated me 80%--loss of index finger left hand, nerve damage to left hand, loss of some thumb movement and flexibility left hand, right finger last joint 0 movement.” 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 - 20051220	VARD - 20060622	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Hand Decreased Function and Pain	5153	20%	Left Hand Index Finger Amputation	5153	20%	20060123	
Healed Right Distal Interphalangeal
Joint Fracture of the Ring Finger	Cat III	Right Hand Ring Finger	5230	0%	20060123	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 60%	

ANALYSIS SUMMARY:

Left Hand Decreased Function and Pain. According to the service treatment record and MEB narrative summary (NARSUM), the right-handed CI’s left hand condition began 12 December 2004 after suffering gunshot wounds to the hands while deployed to a combat zone. The wounds were  debrided  down  range  and  subsequent  surgeries  were  performed  on  14,  20  and     23 December 2004, 19 January 2005 and 4 March 2005. Due to extreme stiffness in the left hand and an insensate feeling that made it relatively useless, the CI underwent a left index finger resection in August 2005. The 11 October 2005 MEB NARSUM examination, 6 months prior to separation, noted complaints of mild left-handed pain with use and he was unable to perform manual tasks or heavy labor. The CI reported doing extremely well since the last surgery and was slowly learning how to play the guitar again. Physical examination showed right hand grip strength of 40/38/36 kilograms (kg) compared to 24/25/23 kg on the left. Pinch strength was 10

kg on the right and 4 kg on the left. His index finger was gone but had a nicely contoured ray resection. He had decent abductor brevis function of his left thumb with full flexion and extension of his thumb and remaining fingers. He had no discrete neuroma formation and vague tenderness with deep palpation. During the next-day MEB examination (recorded on DD Forms 2807-1 and 2808), physical examination revealed an insensate left thumb and the thenar eminence, along with decreased strength, functioning and range of motion (ROM).

At the 23 January 2006 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported left hand pain and an inability to grip and hold objects with the left hand, but he was able to perform activities of daily living. He was also able to perform his usual occupation with only mild restrictions on gripping, lifting and pushing with both hands, especially the left one. There was no loss of time from work. Physical examination showed atrophy of the muscles of the left thumb.

The panel directed attention to its rating recommendation based on the above evidence. The PEB and the VA both rated the left hand condition 20%, coded 5153 (amputation of index finger). The VA based the rating on the C&P examination, citing “amputation of the index finger with metacarpal resection (more than one-half the bone lost).” The NARSUM and C&P examinations noted the amputation of the index finger of the non-dominant left hand. The PEB assigned the maximum 20% rating for amputation of the index finger with metacarpal resection of the non- dominant finger. Panel members agreed there was no higher rating than the 20% assigned by the PEB. 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 left hand condition.

Contended PEB Condition: Healed Fracture of the Right Ring Finger. The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting. The contended condition was not noted on limited duty forms, implicated in the non-medical assessment, and did not fail retention standards. There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation. After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition, so no additional disability rating is recommended.

BOARD FINDINGS: In the matter of the decreased left hand function and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication. In the matter of the contended right ring finger condition, the panel recommends no change from the PEB determination 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.

The following documentary evidence was considered:
2	PD-2017-05579

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

IN REPLY REFER TO:
1850
CORB: 003
10 Sep 20

From: Director, Secretary of the Navy Council of Review Boards To:	

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.