RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

BRANCH OF SERVICE:   USMC 
SEPARATION DATE:  20030515 

 
NAME:  XX 
CASE NUMBER:  PD1200892 
BOARD DATE:  20130215 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty PFC/E-2 (9900/Basic Marine) medically separated for 
bilateral  median  neuropathies.    The  CI  presented  with  neuropathic  conditions  during  recruit 
training  and  was  referred  to  a  Medical  Evaluation  Board  (MEB)  since  he  could  not  complete 
basic  training. 
  The  nerve  condition,  characterized  by  the  MEB  as  “bilateral  median 
neuropathies”,  was  forwarded  to  the  Physical  Evaluation  Board  (PEB)  as  medically 
unacceptable.  No other conditions were submitted by the MEB.  The PEB adjudicated “bilateral 
median neuropathies” as unfitting and rated 20% disability.  The CI made no appeals and was 
medically separated with that service disability rating. 
 
 
CI CONTENTION:  The application states “Even though I had the surgery I have still been in a lot 
of discomfort resulting in lack of sleep which effects my daily life and work.  Sometimes hard to 
function with little sleep.  I wake up every morning tired and in pain in my shoulder and neck.  I 
also can’t lift heavy objects above my head due to lack of strength and instability which causes 
problems at work.  I am an electrician so most of my work is above my head and is difficult to 
perform tasks at times.  Also due to years of overcompensating for my left arm, my right arm is 
now giving me a lot of trouble.  I have pain in my right shoulder and neck it seems like the same 
thing is happening all over again but to the right shoulder now.”[sic].  He 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 bilateral median neuropathies is the 
only condition within the 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 the Correction of Naval Records. 
 
 
RATING COMPARISON:  
 

Service PEB – Dated 20040403 

Condition 

Bilateral median 
neuropathies 

Code 

8615 

Rating 

20%* 

Median neuropathy, right hand 
Median neuropathy, left hand 

↓No Additional MEB/PEB Entries↓ 

S/P L shoulder surgery… 

5099-5024 

Combined:  10% 
* Two ratings of 10% with bilateral factor applied; PEB described as one unfitting condition at 20% 

Combined:  20% 

 
 

 

VA (12 Mo. Post-Separation) – Effective 20030516 
Condition 

Rating 

Exam 

Code 
8615 
8615 

0% 
0% 
10% 

20040511 
20040511 
20040813 

imaging  (MRI)  of  the 

limits. 

improvement 

left  brachial  plexus  was  within  normal 

ANALYSIS SUMMARY:  
 
Bilateral Median Neuropathies Condition.  The CI developed left greater than right numbness 
while doing pull-ups in October 2002 and was thought to have a neuropathy of the radial and 
ulnar  nerves.    He  had  been  engaged  in  intensive  physical  training  to  increase  his  ability  to 
perform  “pull-ups”.    He  was  removed  from  training  and  an  evaluation  begun.    Magnetic 
resonance 
  An 
electrodiagnostic  (EDX)  examination,  done  in  December  2002,  showed  evidence  of  an  upper 
and lower extremity motor and sensory demyelinating polyneuropathy.  CI was subsequently 
evaluated by a neurologist and found to have bilateral sensory changes in the hands and left 
biceps  weakness.    Laboratory  values  and  a  brain  MRI  were  unremarkable.    At  a  follow  up 
neurology  evaluation  that  same  month,  he  reported 
in  his  symptoms.  
Examination  was  remarkable  only  for  persistent  sensory  changes  in  the  left  hand  along  a 
median  nerve  distribution;  the  right  had  sensory  changes  and  left  motor  loss  had  resolved.  
Repeat  EDX  studies  that  day  were  thought  to  be  consistent  with  carpal  tunnel  syndrome, 
median neuropathies at the wrist, left greater than right.  Despite treatment which included 
medications and splints, the CI's symptoms did not resolve.  CI underwent another neurology 
evaluation on 27 Janaury 2003 (4 months prior to separation) at which time a nerve conduction 
study (NCS) showed mild bilateral motor and sensory median neuropathy at wrist, left greater 
than  right.    At  a  physical  medicine  evaluation  on  11  February  2003  (3  months  prior  to 
separation), the CI reported sensation decreased 60% at left index finger and left thumb, good 
motor  function,  no  tenderness  or  atrophy,  full  range-of-motion  (ROM),  and  normal  reflexes.  
The  MEB  examination  was  accomplished  on  21  January  2003,  4  months  prior  to  separation.  
The CI reported numbness in the fingertips of the left hand and inability to lift heavy objects.  
The examiner documented full ROM of the hands and upper extremities with equal sensation 
bilaterally.  A provocative test for carpal tunnel syndrome (Phalens) was positive on the left.  
The MEB narrative summary (NARSUM) dated 28 February 2003 (2 months prior to separation) 
noted that the CI continued to report numbness in his left and right fingertips.  On examination, 
he had no atrophy or tenderness.  He had full ROM of neck, elbow, and wrist.  Upper extremity 
strength  was  normal  bilaterally.    Reflexes  were  symmetric.    The  CI  had  a  patchy,  non-
dermatological decrease in sensation along his palmar finger tips, affecting the thumb, index 
and ring finger on his left and right hand.  The examination was thought to be consistent with 
bilateral median nerve neuropathies.  At a neurological VA Compensation and Pension (C&P) 
exam  on  11  May  2004,  (12  months  post-separation),  the  CI  denied  the  persistence  of  any 
numbness or weakness in either hand.  His neurologic exam was normal, there was no atrophy 
and provocative testing was negative bilaterally.  The neurologist concluded that the left hand 
median nerve neuropathy had completely resolved and that the neurological examination was 
normal.   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB used a single diagnosis (bilateral median neuropathy), but rated each at 10% using code 
8615.  The VA gave separate non-compensable ratings of 0%, also coded 8615, for each arm.  
The Board noted the steady improvement in the examinations after the CI was removed from 
basic training and the resolution of findings at the C&P examination.  The Board unanimously 
concluded  that  the  minimal  sensory  deficit  on  examination,  with  normal  strength  and  ROM, 
would rate no more than "mild median neuropathy" for each arm and thus rate no more than 
the  10%  coded  8615  for  each  arm.    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 bilateral median neuropathies 
condition. 
 
 

2                                                           PD1200892 

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

UNFITTING CONDITION 

VASRD CODE  RATING 

8615 
8615 

COMBINED (w/ BLF) 

10% 
10% 
20% 

Bilateral Median Neuropathies 

 

 

The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120612, w/atchs. 
Exhibit B.  Service Treatment Record. 
Exhibit C.  Department of Veterans’ Affairs Treatment Record. 
 
 
 
 
 
 
 
 

 
 
 

 

xx 
Acting Director 
Physical Disability Board of Review 

3                                                           PD1200892 

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 22 Mar 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: 
 
 
 

 
 

 

 

     
 
 
 
 

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

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

4                                                           PD1200892