RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201480 SEPARATION DATE: 20020512 

BOARD DATE: 20130301 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (73C/Finance) medically separated for 
limited range-of-motion (ROM) in the right elbow. The soldier was involved in an automobile 
accident in April 2001 in which she fractured her left humerus and suffered a degloving injury to 
her right arm. Despite extensive therapy the CI could not be adequately rehabilitated to meet 
the requirements of her Military Occupational Specialty (MOS) or physical fitness standards. 
While being treated at a US Air Force (USAF) hospital she was issued a permanent U4 profile 
and referred for a Medical Evaluation Board (MEB) under the provisions of AFI 48-123, 36-3212, 
and 44-157. The USAF MEB forwarded two diagnoses to the Army PEB; 1) “Motor vehicle 
accident with secondary degloving injury to right upper extremity and fracture of left humerus. 
S/P ORIF and wound I&D” and 2) “Deep Vein Thrombosis LLE, probably secondary to Dgs #1,…”. 
No other conditions were submitted by the MEB. The Physical Evaluation Board (PEB) 
adjudicated “Limited range of motion, right elbow, extension to 45 degrees status post 
degloving injury” as unfitting and rated 10%. The remaining conditions were determined to be 
not unfitting. The CI made no appeals and was medically separated with a 10% disability rating. 

 

 

CI CONTENTION: The application states “Right arm cannot stretch to its full extent, lower back 
pains, plate in left arm, left knee scars with knee pain” The application does not elaborate 
further or specify a request for Board consideration of any additional conditions. 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in 
Department of Defense Instruction (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 rating for the unfitting right elbow condition is addressed 
below. The requested condition of the left arm, which was determined to be not unfitting by 
the PEB, is likewise addressed below. The requested conditions of lower back pain and left 
knee scars/knee pain were not identified by the PEB and thus are not within the DoDI 6040.44 
defined purview of the Board. 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 PEB – Dated 20020207 

VA (# Mo. Post-Separation) – Effective 20020512 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Right Elbow, Limited Extension 
s/p Degloving Injury 

5207 

10% 

Postop. Residuals, Right Elbow; 
Atrophy, Limitation of motion 

5207-5305 

40% 

20020419 

Fracture of left humerus 

Not Unfitting 

Scar… left biceps… 

7804 

10% 

20020419 

Deep Vein Thrombosis LLE... 

Not Unfitting 

Scar… right elbow… 

7804 

10% 

20020419 

.No Additional MEB/PEB Entries. 

Scar, left lateral knee 

7804 

10% 

20020419 

Chronic lumbosacral strain 

5295 

10% 

20020419 

Right knee… 

5024 

10% 

20020419 

0% X 2 / Not Service Connected x 2 

20020419 

Combined: 10% 

Combined: 70% 



 

 

ANALYSIS SUMMARY: The Disability Evaluation System (DES) is responsible for maintaining a fit 
and vital fighting force. While the DES considers all of the member's medical conditions, 
compensation can only be offered for those medical conditions that cut short a member’s 
career, and then only to the degree of severity present at the time of final disposition. The DES 
has neither the role nor the authority to compensate members for anticipated future severity 
or potential complications of conditions resulting in medical separation nor for conditions 
determined to be service-connected by the Department of Veterans Affairs (DVA) but not 
determined to be unfitting by the PEB. However the DVA, operating under a different set of 
laws (Title 38, United States Code), is empowered to compensate all service-connected 
conditions and to periodically re-evaluate said conditions for the purpose of adjusting the 
Veteran’s disability rating should the degree of impairment vary over time. The Board’s role is 
confined to the review of medical records and all evidence at hand to assess the fairness of PEB 
rating determinations, compared to Veterans Administration Schedule of Rating Disabilities 
(VASRD) standards, based on severity at the time of separation. 

 

Right Elbow Condition. The ROM evaluations in evidence which the Board weighed in arriving 
at its rating recommendation, with documentation of additional ratable criteria, are 
summarized in the chart below. 

 

Right Elbow ROM 

(Degrees) 

MEB ~6 Mo. Pre-Sep 

(20011031) 

Ortho ~ 4 Mo. Pre-Sep 

(20020125) 

VA C&P ~1 Mo. Post-Sep 

(20020419) 

Flexion (145 normal) 

135 

145(150) 

145 

Extension (90) 

45 

35 

45 

Comment 

Decreased sensation 

Positive Tinel’s 

Pain in elbow 

Strength improved 

Pronation and supination 
are normal 

Painful motion 

Supination and pronation near 
normal (85, 70) 

§4.71a Rating (Major) 

10% 

0% 

10% 



 

The MEB narrative summary (NARSUM), dictated 31 October 2001 reported that the right hand 
dominant CI injured her right upper extremity, including the right anticubital area in a motor 
vehicle accident. The CI had a degloving injury (peeling away of the skin) which required wound 
irrigation, debridement, and dressing changes. The CI was unable to complete physical training 
(especially push-ups) due to the loss of extension of her right elbow. The MEB examination 
reported that the CI had recovered well, with regards to her right upper extremity injury. The 
examiner noted a well healed wound with ROM as indicated in the chart above. The CI’s motor 
strength was reported as fully intact (5/5). The CI had no sensation in the area of the superficial 
branch of the radial nerve and there was a positive Tinel’s sign at her elbow. Occupational 
therapy examinations 18 December 2001 and 25 January 2002 document mild weakness of the 


right arm including grip. The VA Compensation and Pension (C&P) examination, performed 
19 April 2002, a month after separation, reports that the CI reported persistent and daily 
paresthesia and pain involving her right upper extremity. She also reported bilateral hand 
swelling by the end of most days. The CI was taking analgesic medication for pain and had 
undergone extensive occupational therapy since her accident. The CI was unable to extend her 
right arm past 45 degrees of flexion. The CI reported that she was unable to do household 
chores, perform child care, enjoy certain recreational activities, or gain employment which 
required her to use her right upper extremity. The examiner notes that there is marked muscle 
atrophy secondary to skin expansion procedures. The examination revealed ROM as indicated 
above. Muscle strength in the right arm was 4/5. Sensation was decreased to light touch 
involving the skin distal to right arm antecubital area. Sensation was increased proximal to this 
area. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
PEB rated the right elbow condition using the code 5207, limitation of extension of the forearm 
with a 10% disability and the VA used a combined code, 5207-5305 to include the limitation of 
extension and muscle group dysfunction for a combined rating of 40%. The Board first looked 
at the code 5207, limitation of extension used by both the PEB and VA. The CI’s condition is 
consistent with a 10% disability for elbow extension limited to 45 degrees under the code 5207 
(major or minor upper extremity). The Board then considered the code 5305, muscle group 
function used by the VA. The C&P examination supports a moderate rating under this code and 
is equivalent to 10% disability. Although the MEB NARSUM reported strength to be normal, 
occupational therapy examinations recorded mild weakness similar to the C&P examination. 
Neither of the MEB or the VA examinations supported a severe muscle disability. In its 40% 
rating the CA cited severe muscle atrophy, however there was no direct muscle injury and the 
weakness was the result of disuse during treatment of the skin wound. The skin wound and 
scarring from the skin injury would be expected to give the appearance of atrophy. The 
reduction in strength documented on examinations is moderate consistent with 10% rating. 
The Board agreed that the weakness warranted a separate 10% rating coded 5305 and 
concluded it was based on a separate impairment from the limitation of motion. 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 limitation of extension of the right elbow 
(5207) and a separate 10% rating for weakness (5305). 

 

Contended PEB Conditions. The contended condition adjudicated as not unfitting by the PEB 
was the fracture of the left humerus. The Board’s first charge with respect to these conditions 
is an assessment of the appropriateness of the PEB’s fitness adjudications. The Board’s 
threshold for countering fitness determinations is higher than the VASRD §4.3 (reasonable 
doubt) standard used for its rating recommendations, but remains adherent to the DoDI 
6040.44 “fair and equitable” standard. The CI sustained a left humerus fracture (upper arm) in 
the aforementioned motor vehicle crash and underwent surgical treatment (open reduction 
and internal fixation). The MEB NARSUM noted the left humerus fracture to have healed well. 
Occupational therapy examination 18 December 2001 noted “complete return” of left upper 
extremity. At the C&P examination there was no tenderness or swelling and strength was 
normal. The left humerus condition was not profiled; it was not implicated in the commander’s 
statement. The conditions was reviewed and considered by the Board. There was no 
performance based evidence from the record that the left humerus condition significantly 
interfered with satisfactory duty performance. After due deliberation in consideration of the 
preponderance of the evidence, the Board concluded that there was insufficient cause to 
recommend a change in the PEB fitness determination for the left humerus condition; thus no 
additional disability rating can be recommended. 

 

 


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 elbow condition and IAW VASRD §4.71a, the Board 
unanimously recommends no change in the PEB adjudication. In the matter of the right elbow 
condition, the Board unanimously recommends a disability rating of 10%, coded 5207 IAW 
VASRD §4.71a, and a separate 10% rating for weakness due to muscle injury coded 5305 IAW 
VASRD §4.73. In the matter of the contended left humerus condition, the Board unanimously 
recommends no change from the PEB determination as not unfitting. 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 her prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Right Elbow Condition 

5207 

10% 

Right Arm Weakness 

5399-5305 

10% 

COMBINED 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120614, w/atchs. 

Exhibit B. Service Treatment Record. 

Exhibit C. Department of Veterans Affairs Treatment Record. 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxxxxx, AR20130006224 (PD201201480) 

 

 

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 20% 
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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)