RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201487 SEPARATION DATE: 20020402 

BOARD DATE: 20130307 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (88M20/Motor Transport Operator), 
medically separated for left wrist arthritis. The CI injured her left wrist when she fell on her 
outstretched arm during Army physical training in August 1999. Initial treatments through 
occupational therapy did not resolve her persistent pain. An arthrogram performed in 
December 2000 revealed a triangular fibrocartilage complex (TFCC) tear in her left wrist. She 
had an uncomplicated procedure on 9 February 2001 for arthroscopic debridement and repair 
of her lesion. Chondromalacia of her distal radius was incidentally discovered in surgery. 
Postoperatively, the CI remained with left wrist pain with almost any activities. Her pain 
restricts her ability to perform her job and military duties. There was no relief refractory for her 
pain except for rest. The CI’s left wrist arthritis condition could not be adequately rehabilitated 
to meet the physical requirements of her Military Occupational Specialty (MOS) or satisfy 
physical fitness standards. She 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 left wrist arthritis condition as unfitting, rated 0%, 
with likely application of Veterans Affairs Schedule for Rating Disabilities (VASRD) and AR 40-
501. The CI made no appeals, and was medically separated with a 0% disability rating. The CI is 
right hand dominant. 

 

 

CI CONTENTION: “I have lived with chronic pain since 1994 when I was injured in the Army. My 
condition has worsened since I was last evaluated by the VA. I suffer from severe degenerative 
disease and advanced scoliosis and I am currently under the care of a doctor for pain 
management and physical therapy for the third time to help cope with pain. My job 
perforemance (sic) is limited and very hard to do because I am always in pain. I am forced to 
take pain medication to cope with pain which most of the time restricts me from effectively 
performing on the job. I have considered quitting my job because my pain affects me too often 
on the job. My rest cycle and sleep is limited daily to approximately 3 hours daily because I can 
only lay on the right side of my body. I cannot sleep on my back, stomach, or left side of my 
body. My condition is not curable and I also have issues with the discs in my back as well at this 
point. I am always in pain and pain medication often times do not even work. My disability has 
not only affected me physically but emotionally because I am so limited to what I can do and 
have no tolerance for pain at all. My job as a spouse and a mother is limited because I often 
need help with household duties as well.” 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. The unfitting left wrist arthritis condition 
as requested for consideration meets the criteria prescribed in DoDI 6040.44 for Board 
purview; and, is addressed below. The other requested conditions of back degenerative 
disease, advanced scoliosis, and sleep limitation are not within the Board’s purview. The 
remaining conditions rated by the VA at separation and listed on the DA Form 294 are not 


within the Board’s purview. 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 IPEB – Dated 20020103 

VA – All Effective Date 20020403 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Left Wrist Arthritis 

5003 

0% 

Triangular Fibrocartilage 
Complex (TFCC) Tear, Left Wrist 

5299-5215 

0%* 

STR 

.No Additional MEB/PEB Entries. 

0% X 3 / Not Service-Connected x 4 

STR 

Combined: 0% 

Combined: 0%** 



*Later, VA changed the VA code and rated triangular fibrocartilage complex (TFCC) tear, left wrist at 5003 to 10% 20070330. 
**Later other conditions were added; combined rating increased to 40% from 20070330. 

 

 

ANALYSIS SUMMARY: The Board acknowledges the CI’s contention regarding the significant 
impairment with which her service-connected condition continues to burden her; but, must 
emphasize that the Disability Evaluation System (DES) has neither the role nor the authority to 
compensate members for anticipated future severity or potential complications of conditions 
resulting in medical separation. That role and authority is granted by Congress to the 
Department of Veteran Affairs (DVA), operating under a different set of laws. The Board 
considers DVA evidence proximate 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 to the Board’s recommendations only to the extent that 
it reasonably reflects the disability at the time of separation. 

 

Left Wrist Arthritis Condition. The goniometric range-of-motion (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. 

 

Left Wrist ROM 

(Degrees) 

OT ~12 Mos. Pre-Sep 

MEB ~8 Mos. Pre-Sep 

VA C&P ~70 Mos. Post-Sep 

Dorsiflexion (0-70) 

30 

45 

0-45 

Palmar Flexion (0-80) 

10 

45 

0-40 

Ulnar Deviation (0-45) 

20 

 

0-20 

Radial Deviation (0-20) 

15 

0-20 

Comment: Surgery 14 
Mo. Pre-Sep 

Stiffness & pain; 

Pain w/ PROM 

Painful motion; swollen; 
Neurovascularly intact 

Painful motion 

§4.71a Rating 

10% 

10% 

10% 



 

At the MEB examination (8 months prior to separation and 5 months post-surgery), the CI 
reported continued pain and ache in her left wrist with activities. The examination revealed 
well healed surgical portal scars on the dorsal aspect of the left wrist and her wrist was “grossly 
swollen” with tenderness to the areas of the TFCC and distal radius. There was good muscle 
strength and grip. The exam is summarized above. At the VA Compensation and Pension (C&P) 
examination (70 months post separation), the CI reported left wrist pain specifically worse with 
typing and lifting. Additionally, she reported left wrist stiffness and weakness and the need to 
wear a wrist support brace. The VA exam revealed painful motion without wrist joint ankylosis. 
The exam ROM is summarized above. 

 

The Board directs attention to its rating recommendation based on the above evidence. The 
Board acknowledges the C&P exam was very remote (70 months) to the CI’s date of separation 
and therefore, provides minimal probative value in the rating decision. The Board determined 


that the MEB exam had the highest probative value due to its medical completeness and its 
proximity to the CI’s date of separation. Both the Army and VA rated the CI’s left wrist arthritis 
condition at 0% using 5003 (arthritis) and analogous code 5299-5215 (wrist, limitation of 
motion) respectively. All exams indicated noncompensable ROMs under the appropriate wrist 
code of 5215. The Board considered analogous code of 5003-5014 (Osteomalacia) for the 
chondromalacia condition contributing to her persistent pain. The initial VARD (VA 0% rating) 
noted the CI failed to show for a scheduled VA exam or to submit records of treatment. The 
treatment record consistently documented painful motion of the wrist, and the Board 
conceded painful motion IAW VASRD §4.59 for a major joint IAW VASRD §4.45. After due 
deliberation, considering all of the evidence and mindful of VASRD §4.3 (Resolution of 
reasonable doubt) and §4.59 (Painful motion), the Board recommends a disability rating of 10% 
for the left wrist arthritis 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. As discussed above, PEB 
reliance on the USAPDA pain policy and AR 635-40 for rating left wrist arthritis was operant in 
this case and the condition was adjudicated independently of that policy by the Board. In the 
matter of the left wrist arthritis condition, the Board unanimously recommends a disability 
rating of 10% coded 5003-5014 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 her prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Left Wrist Arthritis 

5003-5014 

10% 

COMBINED 

10% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120825, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxx, AR20130008729 (PD201201487) 

 

 

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 xxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)