RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX 	CASE:  PD-2014-03712
BRANCH OF SERVICE:  Army	sepAration date: 20020927

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E5, Heavy Construction Equipment Operator, medically separated for “chronic pain right shoulder, status post (s/p) two surgical procedures,” with a combined disability rating of 10%.  

CI CONTENTION: “For all conditions!”  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	VA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain Right Shoulder, Status Post (S/P) Two Surgical Procedures	5099-5003	10%	Right Shoulder Pain, S/P Failed Arthroscopic Surgeries	5201-5010	10%	20030905	
			
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 1	
RATING:  10%	RATING: 10%	

ANALYSIS SUMMARY: 

Right Shoulder.  Review of the service treatment record found that the right hand dominant CI injured his right shoulder in October 1997.  Ongoing pain led to an extensive right rotator cuff repair with a subacromial decompression in April 2001.  A shoulder X-ray in April 2001 showed surgical changes without any other pathology.  According to the MEB NARSUM on 6 June 2002 (approximately 4 months prior to separation) the CI complained of right shoulder pain and weakness.  Shoulder dislocations were not reported.  Physical examination showed some tenderness of the right acromioclavicular joint.  Right shoulder flexion was 170 degrees (normal 180 degrees) and abduction was 170 degrees (normal 180 degrees).  There was no muscle atrophy and muscle strength was normal.  

At the VA Compensation and Pension (C&P) exam on 5 September 2003 (approximately 11 months after separation) the CI complained of flare-ups with any use of the shoulder and during the flares he would experience range of motion (ROM) limited to 45 degrees of abduction and flexion.  The CI also reported that lifting more than 20 pounds caused pain, but he could perform activities of daily living.  He denied weakness, and shoulder dislocations were not reported.  Physical examination showed mild tenderness, mild glenohumeral crepitus and mild fatigability.  Right shoulder flexion was 170 degrees and abduction was 130 degrees.  There was no change in ROM with repetitive motion.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating under the analogous 5003 code (Arthritis, degenerative [hypertrophic or osteoarthritis]), citing the US Army Physical Disability Agency (USAPDA) pain policy with pain rated as slight and constant.  The VA assigned a 10% rating under a combination 5201 (Arm, limitation of motion of) and 5010 (Arthritis, due to trauma) code, citing pain limited motion. The VASRD §4.71a threshold for a minimum rating for ROM impairment is “at shoulder level” (90 degrees from the side), and the ROM in evidence demonstrated motion above this level.  Although the limitation of motion did not support a minimum rating, Board members agreed that a 10% rating was justified with application of VASRD §4.59 (painful motion).  There was no malunion or recurrent dislocation of the humerus to justify a rating under the 5202 code (humerus, other impairment of); and no nonunion with loose movement of the clavicle to warrant the next higher 20% rating under the 5203 code (clavicle or scapula, impairment of).  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 right shoulder condition. 

BOARD FINDINGS:  In the matter of the right shoulder 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 re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140621, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB

MEMORANDUM FOR Commander

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXXXXXXX, AR20160009324 (PD201403712)

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.

BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure

CF:
( ) DoD PDBR
( ) DVA