RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:  ARMY 
SEPARATION DATE:  20020421 

 
NAME:  XXXXXXXXXXXX 
CASE NUMBER:  PD1101037 
BOARD DATE:  20130131    
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty SPC/E-4 (95B10/Military Police), medically separated 
for chronic right wrist pain.  The CI incurred a right (dominant) distal radial fracture in 1999, 
recovered,  and  re-injured  his  wrist  in  2000,  requiring  surgery.    The  CI  did  not  improve 
adequately with treatment; therefore he was unable to meet the physical requirements of his 
Military  Occupational  Specialty  (MOS)  or  satisfy  physical  fitness  standards.    He  was  issued  a 
permanent U3 profile and referred for a Medical Evaluation Board (MEB).  The MEB forwarded 
no other conditions for Physical Evaluation Board (PEB) adjudication.  The PEB adjudicated the 
chronic right wrist pain condition as unfitting, coded 5099-5033, and rated 0% with application 
of the US Army Physical Disability Agency pain policy.  The CI appealed and the PEB increased 
the rating to 10% using the Veterans Affairs Schedule for Rating Disabilities VASRD 5024.  The CI 
made no further appeals and he was then medically separated with a 10% disability rating.   
 
 
CI CONTENTION:  The CI elaborated no specific contention in his application.   
 
 
SCOPE OF REVIEW:  The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44, Enclosure 3, paragraph 5.e. (2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.”  The ratings 
for  unfitting  conditions  will  be  reviewed  in  all  cases.    Any  conditions  or  contention  not 
requested in this application, or otherwise outside the Board’s defined scope of review, remain 
eligible for future consideration by the Army Board for Correction of Military Records. 
 
 
RATING COMPARISON:   

 
 
ANALYSIS SUMMARY:  The Board’s authority as defined in DoDI 6040.44, resides in evaluating 
the  fairness  of  Disability  Evaluation  System  fitness  determinations  and  rating  decisions  for 
disability at the time of separation.  The Board utilizes VA evidence proximal to separation in 
arriving  at  its  recommendations;  and,  DoDI  6040.44  defines  a  12-month  interval  for  special 
consideration to post-separation evidence.  Post-separation evidence is probative only to the 
extent  that  it  reasonably  reflects  the  disability  and  fitness  implications  at  the  time  of 
separation. 

 
Service IPEB Reconsideration – Dated 20020131 
Condition 
Chronic  Right  Wrist  Pain 
Secondary to Tenosynovitis 
Combined:  10% 

Rating 
10% 

Code 
5024 

VA (None) – All Effective Date 20020422 
Condition 
Residuals  of  Surgery,  Tenosynovitis, 
Intersectional Syndrome and Fracture 
Combined:  10% 

Code 
5024-5215 

Rating 
10% 

Exam 
STR 

 
Chronic Right Wrist Pain Secondary to Tenosynovitis (Right Wrist Pain) Condition.  There was 
one  goniometric  range-of-motion  (ROM)  evaluation  in  evidence,  with  documentation  of 
additional ratable criteria, which the Board weighed in arriving at its rating recommendation as 
summarized in the chart below.   

 

Right Wrist ROM 
Dorsiflexion (0-70⁰) 
Palmar Flexion (0-80⁰) 
Ulnar Deviation (0-45⁰) 
Radial Deviation (0-20⁰) 

Comment 

§4.71a Rating 

MEB ~5.5 Mo. Pre-Separation 
 
“Lacking 3⁰”; Increased pain with resistance 
“Lacking 5⁰” 
“Full” 
“Full” 
No  mention  of  goniometer;  full  pronation  and  supination;  exquisitely 
tender to palpation of the dorsal, radial side; no swelling; normal motor 
and sensory exam 
10% 

 
In June 1999, the CI fell while playing basketball and sustained a right (dominant) distal radius 
(wrist)  fracture.    After  casting  and  4  months  of  occupational  therapy,  he  had  complete 
resolution of his wrist pain and his ROM was nearly symmetric to the opposite side.  However, 
in  January  2000,  he  re-injured  his  right  wrist  and  developed 
intersection  syndrome, 
tenosynovitis of the second dorsal compartment of the wrist.  His symptoms failed to resolve 
with conservative treatment, multiple injections of steroids, and local anesthetic; he underwent 
a surgical release of the second dorsal compartment in February 2001.  After some initial issues 
with wound healing, the CI regained almost full ROM.  However, he continued to have pain that 
was generally unchanged from and occasionally worse than the pain he had prior to surgery.  
This pain increased with any increased use of his right upper extremity and prevented him from 
performing the tasks required of his MOS.  He was unable to lift or perform any activity that 
required  a  strong  grasp  with  his  right  hand.    An  MEB  narrative  summary  (NARSUM)  was 
completed  approximately  5  months  prior  to  separation  and  the  physical  findings  are  in  the 
chart  above.    An  addendum  to  the  NARSUM  was  completed  approximately  3  months  later, 
clarifying the clinical history and noting the exquisite tenderness noted in the ROM chart above.  
An  X-ray  showed  a  well-healed  distal  radial  fracture.    There  was  no  VA  Compensation  and 
Pension exam present in the record for review; the initial VA rating decision was determined 
using the CI’s service medical records, MEB proceedings, and PEB proceedings. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB and the VA chose slightly different coding options that did not bear on the disability rating.  
The  PEB  coded  the  right  wrist  pain  as  5024  tenosynovitis  based  upon  loss  of  range  of  wrist 
motion rated 10%.  The VA coded the condition as 5024-5215 tenosynovitis--wrist, limitation of 
motion and rated 10% based on the application of §4.59 (Painful motion).  In accordance with 
the  VASRD,  the  rating  of  5024  is  based  upon  the  limitation  of  motion  of  the  affected  joint, 
which  is  the  dominant  wrist  (5215)  in  this  case.    While  the  minimum  compensatory  ROM 
limitation under 5215 is not met, a 10% rating is assigned for painful or pain-limited motion 
IAW §4.59.  Assigning a rating greater than 10% would require either favorable or unfavorable 
ankylosis  but  neither  was  present.    There  is  no  alternative  coding  option  that  would  yield  a 
higher rating for the right wrist pain condition.  After due deliberation, considering all of the 
evidence  and  mindful  of  VASRD  §4.3  (Resolution  of  reasonable  doubt),  the  Board  concluded 
that there was insufficient cause to recommend a change in the PEB adjudication for the right 
wrist pain 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  right  wrist  pain  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 
Chronic Right Wrist Pain Secondary to Tenosynovitis 

VASRD CODE  RATING 
5024 
COMBINED 

10% 
10% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20111104, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

        

 

 
                   XXXXXXXXXXXXXXXXXX, DAF 
                   Director 
                   Physical Disability Board of Review 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / XXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation 
for XXXXXXXXXXXX, AR20130002534 (PD201101037) 
 
 
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 
 
 
 

     XXXXXXXXXXXXXXXX 
     Deputy Assistant Secretary 
         (Army Review Boards)