SAF/MRBD (PDBR)
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

MEMORANDUM FOR THE DIRECTOR, AIR FORCE REVIEW BOARDS AGENCY

SUBJECT:  Physical Disability Board of Review Recommendation on Case Number PD-2019-00077

	In accordance with Title 10 § 1554a and in compliance with DoDI 6040.44, the Physical Disability Board of Review (PDBR) adjudicated the disability rating accompanying the medical separation of the covered individual from the United States Air Force.  After carefully reviewing the application and medical separation case file, the PDBR recommended no re-characterization of the separation or modification of the disability rating previously assigned.  I recommend you accept this proposed decision.

	The covered individual (CI) was an active duty E5, Aircraft Structural Maintenance Craftsman, medically separated for “chronic right wrist pain, status post [S/P] distal radial fracture and percutaneous pinning, with decreased range of motion (ROM) and grip strength” and “chronic right shoulder pain, S/P acromioclavicular joint separation, reconstruction procedure, and arthroscopic subacromial decompression with open distal clavicle excision; with decreased ROM,” rated 10% each, with a combined disability rating of 20%.  The PEB coded the right wrist condition 5003 (degenerative arthritis), citing accordance with DoD and VASRD guidelines.  The VA also rated the right wrist condition 10%, coded 5215 (wrist, limitation of motion), based on the Compensation and Pension (C&P) examination, citing reduced ROM of the right wrist.  Although there was insufficient limitation of motion to support a rating under the 5215 code, panel members agreed that a 10% rating could be justified with application of VASRD §4.59 for painful motion recorded at the narrative summary (NARSUM) and C&P examinations.  The panel noted there was no ankylosis (5214) to support a higher rating.  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 right wrist condition.  

In the matter of the chronic right shoulder pain, the PEB rated 10%, coded the condition 5003, citing accordance with DoD and VASRD guidelines.  The VA rated the right shoulder condition 20%, coded 5201 (arm, limitation of motion), based on the C&P examination, citing abduction of the right shoulder was limited to 90 degrees with pain.  Although there was insufficient limitation of motion to support a rating under the 5201 code, panel members agreed that a 10% rating could be justified with application of VASRD §4.59 for painful motion recorded at the NARSUM examination.  There was no malunion or recurrent dislocation of the humerus to justify a rating under the 5202 code (humerus, other impairment); and no nonunion with loose movement of the clavicle to warrant the next higher 20% rating under the 5203 code (clavicle or scapula, impairment).  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 right shoulder condition.   

SAF/MRB
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

Dear XXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2019-00077.

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 rating modification or re-characterization 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 modification of your disability rating or characterization of your separation is not warranted.  Accordingly, I accept the recommendation that your application be denied.