RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  	CASE:  PD1201714
BRANCH OF SERVICE:  Army	BOARD DATE:  20130430
SEPARATION DATE:  20020820

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (63S10/Heavy Wheel Vehicle Mechanic) medically separated for a left index finger condition.  The CI was injured when his left index finger got caught between a semi-table top and a forklift plate, at work in March 2000.  After extensive repair, he developed significant post-traumatic osteoarthritis.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards.  He was issued a permanent P3 profile and referred for a Medical Evaluation Board (MEB).  The post-traumatic arthritis of the left index proximal interphalangeal (PIP) joint condition was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other conditions were submitted by the MEB.  The PEB adjudicated post-traumatic arthritis of the left index PIP joint as unfitting rated 10% with application of the Veterans Administration Schedule for Rating Disabilities (VASRD).  The CI made no appeals, and was medically separated with a 10% disability rating.

CI CONTENTION:  “VA rated Asthma at 30% in original rating.”  

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e. (2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI.  The ratings for the unfitting post-traumatic arthritis of the left index PIP joint condition is addressed below.  The contended asthma condition is not within the DoDI 6040.44 defined purview of the Board.  Any conditions or contentions not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Board for Correction of Military Records.

RATING COMPARISON:  

Service IPEB – Dated 20020607	VA -  Based on Service Treatment Records (STR)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Posttraumatic Arthritis of the Left Index PIP Joint	5003	10%	Posttraumatic Arthritis of the Left Index PIP Joint	5225-5010	0%	STR 	
No Additional MEB/PEB Entries	Other x 1	 	
Combined:  10%	Combined:  30%	

ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed by the CI regarding the impairment with which his conditions continue to burden him, and the significant impact they have had on his quality of life.  It is noted for the record that the Board is subject to the same laws for disability entitlements as those under which the Disability Evaluation System (DES) operates.  The DES has neither the role nor the authority to compensate members for future severity or potential complications of conditions.  That role and authority is granted to the Department of Veterans’ Affairs (DVA).  The Board evaluates DVA evidence in arriving at its recommendations, but its authority resides in evaluating the fairness of DES fitness and rating determinations at the time of separation.  While the DES considers all of the CI's medical conditions, compensation can only be offered for those conditions that cut short a member’s career, and then only to the degree of severity present at the time of separation.  The DVA, however, is empowered to compensate for service-connected conditions and to periodically re-evaluate conditions for the purpose of adjusting the Veteran’s disability rating should the degree of impairment change over time.

Left Index Finger Condition.  The CI suffered a traumatic injury of his non dominant left index finger which required surgical intervention without complications.  The CI developed stiffness and pain with X-ray confirmed post-traumatic arthritis.  He reported that he was unable to do any heavy lifting and that the finger worsened with the mechanical duties and cold weather.  The pain was controlled with pain medications.  The permanent profile and the commander’s statement identified and specified limitations specific for his left index finger condition to include no pushups, no lifting greater than 10 pounds and to use left hand as tolerated.

The MEB physical exam, 9 months prior to separation, demonstrated a swollen, tender joint that had crepitance and extreme pain with range-of-motion (ROM).  The ROM of the PIP joint was from 10 degrees to 25 degrees (0-100 normal).  X-rays revealed a bony union with evidence of early arthritis in that joint.  The VA rating decision based their decision on the service treatment record.

The Board directs attention to its rating recommendation based on the above evidence.  The PEB and VA chose different coding options for the condition IAW §4.71a Schedule of ratings–musculoskeletal system, but this did not bear on rating.  The PEB assigned a 10% rating coded 5003 (arthritis, degenerative) which is consistent with minimum 10% rating criteria for a swollen, limited painful joint.  The VA assigned a 0% rating coded analogous to 5010 (arthritis, traumatic) to 5225 (index finger, ankylosis of unfavorable or favorable) which is inconsistent.  The evidence supports a 10% rating under either of those codes.  Furthermore, the Board notes the evidence supports a minimum 10% rating with consideration of VASRD §4.59 (painful motion).  There is no viable approach to a higher or additional rating for the left index finger condition which is countenanced by the VASRD in the absence of peripheral nerve involvement, scar disfigurement or incapacitating episodes.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the left index finger condition.

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.  In the matter of the left index finger condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.

RECOMMENDATION:  The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination, as follows:  

UNFITTING CONDITION	VASRD CODE	RATING	
Post-traumatic Arthritis of the Left Index PIP Joint	5003	10%	
COMBINED	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20120724, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans’ Affairs Treatment Record

	Physical Disability Board of Review

SFMR-RB									

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(TAPD-ZB), 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for AR20130010773 (PD201201714)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a,   I accept the Board’s recommendation and hereby deny the individual’s application.  
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:

Encl						
						         (Army Review Boards)

CF: 
(  ) DoD PDBR
(  ) DVA