RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

BRANCH OF SERVICE:   NAVY 
SEPARATION DATE:  20080128 

 
NAME:    
CASE NUMBER:  PD1200789 
BOARD DATE:  20130103 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty DC2/E-5 (Damage Control Man), medically separated 
for a left distal radius fracture.  The condition was a consequence of a motorcycle accident in 
September  2005  and  required  multiple  surgical  procedures.    Despite  lengthy  occupational 
therapy  and  surgical  repairs  the  CI  did  not  improve  adequately  with  treatment  to  meet  the 
physical requirements of his rating and was referred for a Medical Evaluation Board (MEB).  The 
MEB  forwarded  other  closed  fractures  of  distal  end  of  radius,  malunion  of  fracture  and 
nonunion of fracture to the Informal Physical Evaluation Board (IPEB) as medically unacceptable 
IAW  SECNAVINST  1850.4E.    Triangular  fibro-cartilage  complex  tear  (TFCC)  and  left  proximal 
fibula  fracture,  listed  in  the  rating  chart  below,  were  also  identified  by  the  MEB.    The  IPEB 
adjudicated  the  left  and  right  distal  radius  fractures  as  unfitting,  rated  10%  each  with 
application of the Veteran’s Affairs Schedule for Rating Disabilities (VASRD).  The TFCC tear with 
ulnar styloid non-union, right distal radius fracture and status post  (s/p) motorcycle accident 
with bilateral distal radius fractures were determined to be related Category II diagnoses.  Left 
proximal  fibular  fracture  was  considered  an  uncategorized  diagnosis.    A  Formal  PEB  (FPEB) 
upheld the 10% rating for the left distal radius fracture and the related Category II condition, 
TFCC  tear;  but  the  right  distal  radius  fracture  and  the  left  proximal  fibular  fracture  were 
adjudicated as Category III: conditions that are not separately unfitting and do not contribute to 
the unfitting condition.  The CI was medically separated with a 10% disability rating. 
 
 
CI  CONTENTION:    “The  injuries  received  rendering  the  member  unfit  include  bilateral  distal 
radius fractures, bilateral ulnar styloids, left fibular fracture, right knee lateral meniscus tear, 
and moderate traumatic brain injury with residual cognitive disorder.  The first PEB conducted 
on or around 27 June 2007, rendered a combined disability rating of 20%.  While the member 
disagreed with the 20% rating, the member requested a formal PEB hearing.  The members of 
the formal PEB hearing conducted on 11  October 2007 did not hear all of the accounts that 
make the member unfit for duty and then lowered the past PEB finding from 20% to 10%.  The 
injuries that were not accounted for included the moderate traumatic brain injury with residual 
cognitive disorder and right knee lateral meniscus tear.  Also concluding the right wrist injuries 
are not unfitting were improperly decided.  The Department of Veterans Affairs current ratings 
are  proof  of the  facts  that the  member  should  have been found  unfit for  active duty  with a 
disability rating 30% or greater.  As a Damage Controlman in the US Navy, the member could 
not have completed the required tasks for the high demanding position and requirements.  Due 
to  the  traumatic  brain  injury,  the  member  experiences  impaired  thinking,  decrease  in  work 
efficiency, periods to preform occupational tasks, memory impairment, difficulty concentrating, 
and  fatigue.    Since  the  injuries  occurred,  the  member  experiences  continued  pain  in  the 
affected extremities.  Even though, the right knee lateral meniscus tear was repaired while on 
active duty, the meniscus continues to tear.  Continued service in the US Navy was impossible 
for the member.  But the disability rating given was incomplete and not accurate. The member 
is requesting the PDBR to review and reevaluate the case at hand for medical retirement with a 
disability rating of 30% or greater.”  [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 conditions right distal radius fracture 
and left proximal fibular fracture as requested for consideration meet the criteria prescribed in 
DoDI  6040.44  for  Board  purview;  and,  are  addressed  below,  in  addition  to  a  review  of  the 
ratings for the unfitting left distal radius fracture and related TFCC tear conditions.  The right 
knee lateral meniscus tear and traumatic brain injury (TBI) with residual cognitive disorder 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 Board for Correction of Naval Records. 
 
 
RATING COMPARISON: 
 

VA (8 Mos. Post-Separation) – All Effective Date 20080129 

Service FPEB – Dated 20071011 
Code 
5215 

Condition 

Rating 
10% 

Left Distal Radius Fracture 
TFCC Tear, Ulnar Styloid Nonunion 
Right Distal Radius Fracture 
Left Proximal Fibular Fracture 

CAT II 
CAT III 
CAT III 

Condition 

Left Wrist Degenerative Joint 
Disease 
Right Wrist Fracture 
Left Knee Strain 
Cognitive Disorder, TBI 
Lumbar Strain 
Neck Strain 
Right Knee Strain 

Code 

5215-5212 
5215-5212 
5014-5260 
8045-9304 

5237 
5237 

5014-5260 
0% X 3 / Not Service-Connected x 2 

Combined:  60% 

Rating 
10% 
10% 
10% 
30% 
10% 
10% 
10% 

Exam 

20081009 
20081009 
20081009 
20080701 
20081009 
20081009 
20081009 
20081009 

↓No Additional MEB/PEB Entries↓ 

Combined:  10% 

 
 
ANALYSIS SUMMARY:  The Board acknowledges the CI’s contention that suggests ratings should 
have been conferred for other conditions documented at the time of separation.  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 his degree of impairment vary over time.  Furthermore, 
with regard to the CI’s assertion that the FPEB’s adjudication of the right wrist was improperly 
decided, the Board must note for the record that it has neither the jurisdiction nor authority to 
scrutinize or render opinions in reference to suspected service improprieties in the disposition 
of a case. 
 
Left Distal Radius Condition.  The CI is right hand dominant.  There were two goniometric range-
of-motion  (ROM)  evaluations  in  evidence,  with  documentation  of  additional  ratable  criteria, 
which the Board weighed in arriving at its rating recommendation, as summarized in the chart 
below. 
 
 
 
 
 
 
 

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Left Wrist ROM 

Dorsiflexion (0-70⁰) 
Palmar Flexion (0-80⁰) 
Ulnar Deviation (0-45⁰) 
Radial Deviation (0-20⁰) 
Forearm Pronation (0-80⁰) 
Forearm Supination (0-85⁰) 

Comment 

MEB ~8 Mo. Pre-Sep 

VA C&P ~8 Mo. Post-Sep 

57⁰ 
29⁰ 
18⁰ 
10⁰ 
56⁰ 
50⁰ 

 

40⁰ 
25⁰ 
30⁰ 
10⁰ 
-- 
-- 

+Painful motion 

§4.71a Rating 

20% 

10% 

 
The narrative summary (NARSUM) noted an inability to carry more than 10 pounds, perform 
push-ups, turn wrenches or use his hands for more than 15 minutes due to pain.  Examination 
noted well healed surgical scars of the wrist; redness and swelling were also present.  At the VA 
Compensation and Pension (C&P) exam performed 8 months after separation, the CI reported 
pain severity at rest of 2 on a 0-10 scale which increased to 6/10 with activity.  He was unable 
to do push-ups.  Examination revealed no loss of motion with repetition. 
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB  assigned  a  10%  rating  under  a  5215  code  (wrist,  limitation  of  motion  of).    Although the 
dorsiflexion and palmar flexion in evidence was non-compensable under that code, there was 
sufficient evidence of pain with use (§4.40) and painful motion (§4.59) to justify a 10% rating 
IAW  §4.71a.    The  VA’s  10%  rating  was  assigned  under  a  combination  5212  code  (radius, 
impairment  of;  Malunion  of,  with  bad  alignment).    While  the  respective  ratings  were 
appropriate under the codes used by the PEB and the VA, the Board considered an alternate 
coding pathway to a higher rating.  Under the 5213 code (elbow and forearm, supination and 
pronation, impairment of), motion lost beyond the last quarter of the pronation arc warrants a 
20%  rating.    Since  full  pronation  is  80  degrees,  the  56  degree  pronation  reported  by  the 
NARSUM examiner meets this higher rating criterion.  The Board agreed that the left triangular-
fibrocartilage  complex  tear  with  ulnar  styloid  nonunion  condition  was  properly  subsumed 
under the unfitting distal radius fracture condition as a related Category II diagnosis.  After due 
deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the 
Board recommends a disability rating of 20% for the left distal radius fracture condition, coded 
5213. 
 
Contended PEB Conditions.  The contended conditions adjudicated as not unfitting by the PEB 
were right distal radius fracture and left proximal fibular fracture.  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.  These conditions did not carry 
attached duty limitations and were not implicated in the non-medical assessment (NMA).  Both 
conditions  were  reviewed  and  considered  by  the  Board.    There  was  no  indication  from  the 
record  that  either  of  these  conditions  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  either  of  the  contended  conditions;  and,  therefore,  no  additional 
disability ratings 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 

   3                                                           PD1200789 
 

were  exercised.    In  the  matter  of  the  left  distal  radius  fracture  condition,  the  Board 
unanimously  recommends  a  disability  rating  of 20%,  coded  5213  IAW  VASRD  §4.71a.    In the 
matter of the contended right distal radius fracture and left proximal fibular fracture, the Board 
unanimously recommends no change from the PEB determinations 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 his prior medical separation: 
 

UNFITTING CONDITION 

VASRD CODE  RATING 

5213 

COMBINED 

20% 
20% 

Left Distal Radius Fracture 

 
 
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 
 
 
 
 
 
 
 
 

 

             
           President 
           Physical Disability Board of Review 

   4                                                           PD1200789 
 

      
 

                           

           COMMANDER, NAVY PERSONNEL COMMAND 
            

MEMORANDUM FOR DEPUTY COMMANDANT, MANPOWER & RESERVE AFFAIRS 
 
 
Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS           
 
Ref:   (a) DoDI 6040.44 
          (b) PDBR ltr dtd 17 Feb 12  
          (c) PDBR ltr dtd 26 Dec 12  
          (d) PDBR ltr dtd 8 Jan 13 ICO  
          (e) PDBR ltr dtd 14 Jan 13 ICO 
 
                                         
1.  Pursuant to reference (a) I approve the recommendations of the Physical Disability Board of Review set forth in 
references (b) through (e). 
 
2.  The official records of the following individuals are to be corrected to reflect the stated disposition: 
 
 
with entitlement to disability severance pay effective the date of discharge. 
 
 
percent) with entitlement to disability severance pay effective the date of discharge. 
 
 
percent) with entitlement to disability severance  pay effective the date of discharge.  

b.  former USMC:  Disability separation with a final disability rating of 20 percent (increased from 10 

c.  former USN:  Disability separation with a final disability rating of 20 percent (increased from 10 

a.  former USN:  Disability separation with a final disability rating of 10 percent (increased from 0 percent) 

 
d.  former USN:  Disability separation with a final disability rating of 20 percent (increased from 10 

 

percent) with entitlement to disability severance pay effective the date of discharge. 
 
3.  Please ensure all necessary actions are taken, included the recoupment of disability severance pay if warranted, to 
implement these decisions and that subject members are notified once those actions are completed. 
 
 
 
 
 
 
 
 
 

    
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

 
 
 

 
 
 

 
 
 

 
 
 

 
 
 

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