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AF | PDBR | CY2012 | PD-2012-00670
Original file (PD-2012-00670.pdf) Auto-classification: Denied
RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

SEPARATION DATE:  20021024 

 
NAME: XXXXXXXXXXXXXX                                                                    BRANCH OF SERVICE: ARMY 
CASE NUMBER:  PD1200670 
BOARD DATE:  20121207 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty Soldier, SGT/E‐5 (77F/Petroleum Supply Specialist), 
medically separated for left elbow pain.  The CI injured his left elbow in 2001, and experienced 
persistent  elbow  pain  despite  non‐operative  management.    The  condition  could  not  be 
adequately  rehabilitated  and  the  CI  did  not  improve  adequately  to  meet  the  physical 
requirements  of  his  Military  Occupational  Specialty  (MOS).    He  was  issued  a  permanent  U3 
profile and referred for a Medical Evaluation Board (MEB).  The MEB forwarded left elbow loose 
bodies status post dislocation as medically unacceptable IAW AR 40‐501.  The MEB forwarded 
no other conditions for Physical Evaluation Board (PEB) adjudication.  The PEB adjudicated the 
pain left elbow, as unfitting, rated 0% with application of the US Army Physical Disability Agency 
(USAPDA)  pain  policy.    The  CI  made  no  appeals,  and  was  medically  separated  with  a  0% 
disability rating. 
 
 
CI  CONTENTION:  The  CI  states:  “Left  elbow  fracture  of  coronoid  process  with  loose  joint 
fragments.    I  gave  the  military  12  years  and  a  [sic]  elbow  and  that  was  worth  0%.    I  wear  a 
elbow  brace  everyday  and  tired  of  fighting  them.  How  could  the  PEB  grant  me  0%  but  the 
hospital in Landstuhl Germany grant me 10% without the physical. I was unable to attend the 
physical because I was place on 24 hour staff duty the day before.  The physical was scheduled 
during my clearing process and I could not reschedule.  If I could have attended the physical I 
know I should have at least been granted 30%.  I had a wife and 3 children to worry about and 
put their needs first.  I trust this board will make the right decision and grant me and my family 
what we justly deserve.”  [sic] 
 
 
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:   
 

*Service Treatment Record 
**VA  decisions  on  20050928  and  20120125  increased  two  non‐PEB  conditions  to  10%  and  30%,  effective  20050413  and 
20100713; combined 20%, then 40% 
 

Service PEB – Dated 20020808 

Condition 

Code 

Pain Left Elbow 

5099‐5003 

Rating
0% 

↓No Addi(cid:415)onal MEB/PEB Entries↓ 

Combined:  0% 

VA  – All Effective Date 20021025 

Condition

Code 

Left Elbow Coronoid Process 
Fracture w/Loose Fragments

5099‐5024 
0% X 1 / Not Service‐Connected x 0 

Combined: 10%** 

Rating 
10% 

Exam
STR* 
STR

ANALYSIS SUMMARY: 
 
Left Elbow Condition.  The CI injured his non‐dominant left elbow on 31 March 2001 when he 
fell  backwards  while  playing  with  his  son.    Evaluation  revealed  an  avulsion  fracture  of  the 
coronoid process of the elbow joint.  Although it was not evident at the initial emergency room 
visit, the description of the injury was thought to be consistent with an elbow dislocation, which 
spontaneously  reduced.  The 
injury  was  treated  with  casting  followed  by  aggressive 
occupational therapy, and full range‐of‐motion (ROM) was regained.  Pain, particularly with full 
extension, continued.  A CT scan performed in March 2002 showed multiple loose bodies about 
the  elbow  joint.    The  CI  declined  a  surgical  option,  since  the  benefit  was  considered  by  the 
orthopedist  to  be  uncertain. 
in  evidence,  with 
documentation of additional ratable criteria, which the Board weighed in arriving at its rating 
recommendation, as summarized in the chart below. 
 

  There  were  two  ROM  evaluations 

Left Elbow ROM 
Flexion (0‐145⁰) 
Pronation (0‐80⁰) 
Supination (0‐85⁰) 

Ortho ~9 Mos. Pre‐Sep 

Ortho ~4 Mos. Pre‐Sep 

0‐135⁰ 

Not specified 

0‐140⁰ 

“Full” 

Comment 

+Tenderness, painful motion 

+Tenderness 

§4.71a Rating 

10% 

10% 

 
The  narrative  summary  (NARSUM)  examiner  indicated  that  the  elbow  pain  was  occasionally 
accompanied  by  a  catching  sensation.    Firing  a  weapon  from  a  prone  position,  heavy  lifting, 
climbing  into  military  vehicles,  carrying  a  rucksack  and  doing  pushups  was  difficult.    Physical 
examination showed full pronation and supination of the elbow and tenderness at the lateral 
ulno‐humeral joint.  Loose bodies were not palpable.  The first VA Compensation and Pension 
(C&P)  exam  was  performed  over  2‐1/2  years  after  separation.    The  CI  complained  of  painful 
motion associated with a popping sensation in the elbow.  Pain prevented lifting, pushing and 
some sports participation.  He denied locking.  Examination revealed a prominence at the left 
radial head.  Extension and flexion was 0‐170 degrees, and pronation and supination were full.  
Repetition of motion produced an audible and palpable click.  There was no instability.  
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB’s DA Form 199 reflected application of the USAPDA pain policy for rating.  The presence of 
non‐compensable limitation of motion, as well as sufficient evidence of functional loss (§4.40) 
and painful motion (§4.59), supported a 10% rating under §4.71a standards.  The Board could 
find no support for rating higher than 10% under alternate elbow or forearm codes.  After due 
deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the 
Board recommends a disability rating of 10% for the left elbow 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.    As  discussed  above,  PEB  reliance  on  the  USAPDA  pain  policy  for  rating  the 
elbow pain was operant in this case and the condition was adjudicated independently of that 
policy  by  the  Board.    In  the  matter  of  the  pain  left  elbow  condition,  the  Board  unanimously 
recommends a disability rating of 10%, coded 5099‐5003 IAW VASRD §4.71a.  There were no 
other conditions within the Board’s scope of review for consideration. 
 
RECOMMENDATION:  The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of his prior medical separation: 

   2                                                           PD1200670 
 

VASRD CODE  RATING
5099‐5003 
COMBINED 

10%
10%

 

Pain Left Elbow 

UNFITTING CONDITION

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120606, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 
 

SFMR‐RB 
 

 
 

 

 

           XXXXXXXXXXXXXXXX, DAF 
           President 
           Physical Disability Board of Review 

 
 

 

 
 

 
 

 
 

 

 

 

 
 
 
 

MEMORANDUM FOR Commander, US Army Physical Disability Agency  

(TAPD‐ZB / XXXXXXXXX), 2900 Crystal Drive, Suite 300, Arlington, VA  22202‐3557 

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  

for XXXXXXXXXXXXXXXXXXX, AR20120022747 (PD201200670) 

1.  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 to modify the individual’s disability rating to 10% without recharacterization 

of the individual’s separation.  This decision is final.   

2.  I direct that all the Department of the Army records of the individual concerned be corrected 

accordingly no later than 120 days from the date of this memorandum.    

3.  I request that a copy of the corrections and any related correspondence be provided to the 
individual concerned, counsel (if any), any Members of Congress who have shown interest, and 

to the Army Review Boards Agency with a copy of this memorandum without enclosures. 

BY ORDER OF THE SECRETARY OF THE ARMY: 

Encl 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

     XXXXXXXXXXXX 

     Deputy Assistant Secretary 
         (Army Review Boards) 

   3                                                           PD1200670 
 

 

 

 
CF:  

(  ) DoD PDBR 

(  ) DVA 
 

 

 

 

 

 

   4                                                           PD1200670 
 



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