RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX                                            	CASE:  PD-2014-03536	
BRANCH OF SERVICE:  Army        	Separation Date:  20030908

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a National Guard, E-6, Cook, medically separated for “chronic pain, left shoulder, status post rotator cuff repair, arthroscopic subacromial decompression and acromioclavicular joint resection,” with a disability rating of 10%.  

CI CONTENTION:  The applicant requests consideration of all conditions in his application.  The CI’s complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB – 20030603	VARD	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Shoulder Pain	5099-5003	10%	Impingement Left Shoulder with Torn Rotator Cuff	5201	20%	NO EXAM	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Left Shoulder Pain.  The CI was diagnosed with traumatic impingement with a probable rotator cuff tear in 2001.  A magnetic resonance imaging study showed a tear of the supraspinatus tendon.  He underwent a rotator cuff repair on 25 May 2001 and an arthroscopy with capsular debridement, subacromial decompression, and acromioclavicular joint resection with rotator cuff repair on 26 March 2002.  Despite the physical therapy and steroid injection, the CI continued to report pain limited range of motion (ROM) with activities.  A left shoulder X-ray in January 2003 showed no evidence of glenohumeral degenerative joint disease and an adequate debridement with decompression.  

At the MEB narrative summary (NARSUM) examination, approximately 5 months prior to separation, the CI reported mild pain, improved ROM, and continued rehabilitation (physical therapy and a home exercise program).  He was unable to perform overhead activities with his left arm, sleep on his left side, perform push-ups, or play any recreational sports.  There were physical examination findings of goniometric ROM of flexion to 112 degrees (180 normal) and abduction to 105 degrees (180 normal); 5/5 strength shoulder strength; tenderness to palpation (TTP) over acromioclavicular joint; mild TTP with cross arm adduction; minimally positive with Neer testing (subacromial impingement); and a mildly positive Hawkins sign (supraspinatus tendon impingement).  The CI is right hand dominant.  The examiner rated the pain in accordance with the American Medical Association as moderate and frequent.  The CI was not scheduled for a VA Compensation and Pension exam. 

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left shoulder pain condition at 10%, coded 5099- 5003 (Arthritis, degenerative).  The VA rated the condition at 20%, coded 5201 (Arm, limitation of motion of).  The Board considered whether the evidence supported a higher than 10% rating.  The MEB NARSUM examination which was proximate to separation showed ROM limited painful motion for the application of VASRD §4.59 (Painful motion) for a 10% rating.  The MEB NARSUM goniometric abduction measurement was 105 degrees which exceeded the 20% rating criteria of at shoulder level (90 degrees).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the left shoulder pain condition.

BOARD FINDINGS:  In the matter of the left shoulder pain 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.  The Board, therefore, recommends that there be no recharacterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140725 w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB

28 JUL 2016

MEMORANDUM FOR Commander, US Army Physical Disability Agency
(AHRC-00), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXXXXX, AR20160008180 (PD201403536)

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 and hereby deny the individual's application.
This decision is final. The individual concerned, counsel (if any), and any Members of
Congress who have shown interest in this application have been notified of this decision
by mail.

Enclosure

CF:
( ) DoD PDBR
( ) DVA