RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXX 
BRANCH OF SERVICE:  NAVY 
CASE NUMBER:  PD1200672                                                                  SEPARATIONDATE:  20020731 
BOARD DATE:  20130125 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty  PO2/E-5  (BU2/Builder  Second  Class),  medically 
separated for bilateral carpal instability.  The CI could not be adequately rehabilitated to meet 
the physical requirements of the rating or satisfy physical fitness standards.  He was placed on 
limited duty (LIMDU) and referred for a Medical Evaluation Board (MEB).  The MEB forwarded 
no other conditions for Physical Evaluation Board (PEB) adjudication.  On 30 October 2001, the 
PEB  adjudicated  bilateral  carpal  instability  as  unfitting,  rated  10%  and  10%,  with  likely 
application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI appealed, 
requesting that he be placed on permanent LIMDU during his wife’s pregnancy.  This request 
was  granted;  however,  this  necessitated  a  second  exam  and  PEB  which,  on  13  June  2002, 
validated the original decision.  The CI was medically separated and released from active duty 
due to medical disability with a 20% disability rating. 
 
 
CI CONTENTION:  “My disability, which I still have, was rated by the VA at 40% as soon as I was 
Idischarged.  This  condition  has  worsened  since  I  got  discharged  by  the  Navy  and  have  been 
rated at a higher percentage.” 
 
 
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.    Ratings  for  unfitting  conditions  will  be 
reviewed  in  all  cases.    The  rating  for  the  unfitting  bilateral  carpal  instability  condition  is 
addressed below; and, no additional conditions are 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 Board for 
Correction of Naval Records. 
 
 
RATING COMPARISON:   
 

Service IPEB #2 – Dated 20020613 
Code 
Condition 
5299-5003 
Bilateral Carpal Instability 
5299-5003 

Rating 
10% 
10% 

No Additional MEB/PEB Entries 

Combined:  20% 

VA (8 Mos. Pre-Separation) – All Effective Date 20020801 
Rating 
Condition 
Right Wrist Carpal Instability 
10% 
10% 
Left Wrist Carpal Instability 
10% 
Right Shoulder Strain 
10% 
Right Hip Strain 
Tinnitus 
10% 
0% X 2 / Not Service-Connected x 4 
Combined:  40% 

Code 
8515-5215 
8515-5215 
5299-5201 
5253 
6260 

Exam 
20011212 
20011212 
20011212 
20011212 
20011212 
20011212 

 
 
ANALYSIS SUMMARY:  The Board acknowledges the sentiment expressed in the CI’s application, 
that he was rated 40% by the VA upon discharge.  The Board wishes to clarify that it is subject 

to  the  same  laws  for  disability  entitlements  as  those  under  which  the  Disability  Evaluation 
System  (DES)  operates.    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.  
However,  the  Department  of  Veterans  Affairs  (DVA),  operating  under  a  different  set  of  laws 
(Title 38, United States Code), is empowered to compensate all service-connected conditions 
and  to  periodically  reevaluate  said  conditions  for  the  purpose  of  adjusting  the  Veteran’s 
disability  rating  should  the  degree  of  impairment  vary  over  time.    The  Board  utilizes  DVA 
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.    The  Board’s 
authority as defined in DoDI 6040.44, however, resides in evaluating the fairness of DES fitness 
determinations  and  rating  decisions  for  disability  at  the  time  of  separation  and  is  limited  to 
conditions adjudicated by the PEB as either unfitting or not unfitting.  Post-separation evidence 
therefore  is  probative  only  to  the  extent  that  it  reasonably  reflects  the  disability  and  fitness 
implications at the time of separation. 
 
Bilateral carpal instability Condition.  The narrative summary a year prior to separation notes 
the right hand dominant CI presented with bilateral wrist pain in October 2000 without acute 
trauma and injury.  Multiple falls and a right wrist sporting injury were noted in the CI service 
treatment  record.    The  CI  was  initially  diagnosed  with  bilateral  wrist  sprain  and  was  treated 
with  activity  modification  and  pain  medications  without  relief  of  pain  symptoms.    The  CI 
continued to have left greater than right wrist pain with activity.  An arthrogram demonstrated 
bilateral pooling at the scapholunate (SL) and lunotriquetral (LT) spaces.  The CI was diagnosed 
with carpal instability combined (CIC) and underwent a left midcarpal injection and short arm 
casting.  Some pain reduction was documented.  A reduction in grip strength was also noted.  
Examination revealed bilateral tenderness at the SL and LT ligaments, and specific maneuvers 
for carpal instability were positive bilaterally.  Decreased grip strength was present on the left.  
At  the  VA  Compensation  and  Pension  examination  8  months  prior  to  separation,  the  CI 
reported locking and pain in both wrists.  The examination documented decreased range-of-
motion (ROM) with repetitive motion with 5/5 motor strength and no incoordination of motion.  
The  examiner  noted  normal  wrist  range  of  motion  bilaterally  in degrees:    dorsiflexion  to  70, 
palmar flexion to 80, ulnar deviation to 45, and radial deviation to 20. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB rated the bilateral carpal instability at 10% for each hand coded 5299-5003, for a combined 
20% rating.  The VA coded 8515-5215 the bilateral carpal instability wrist limitation of motion 
analogous  to  a  mild  incomplete  medial  nerve  paralysis  and  arrived  at  the  same  20%  rating 
recommendation.  VASRD §4.71a provides only one code for limited motion at the wrist (5215), 
which confers a maximum rating of 10% independent  of the severity of ROM impairment or 
extremity  dominance.    Alternate  coding  using  5003  criteria  for  painful  non-compensable 
limitation of motion is supported, but would not yield a higher rating recommendation.  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 bilateral carpal instability 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  bilateral  carpal  instability  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. 

   2                                                           PD1200672 
 

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

UNFITTING CONDITION 
Bilateral Carpal Instability 

VASRD CODE  RATING 
5299-5003  
5299-5003 

Right 
Left 
COMBINED (w/ BLF) 

10% 
10% 
20% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120608, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

           XXXX 
           Director 
           Physical Disability Board of Review 

   3                                                           PD1200672 
 

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW 
                                     BOARDS  

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 

Ref:   (a) DoDI 6040.44 

             (b) CORB ltr dtd 08 Feb 13 
 

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for 
the reasons provided in their forwarding memorandum, approve the recommendations of the PDBR 
that the following individual’s records not be corrected to reflect a change in either characterization 
of separation or in the disability rating previously assigned by the Department of the Navy’s 
Physical Evaluation Board: 
 
 

 

 

 

     

 
 
 
 

-  xx former USMC 
-  xx former USMC 
-  xx former USN  
-  xx former USMC 
-  xx former USMC 
-  xx former USN  
  

 

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

xxxxx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

   4                                                           PD1200672