RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00624
BRANCH OF SERVICE:  Navy 	SEPARATION DATE:  20050601

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Sonar Technician, medically separated for “right shoulder recurrent posterior inferior instability” with a disability rating of 20%.  

CI CONTENTION:  The CI requested review 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 based upon a 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 - 20050223	VARD - 20080509	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Shoulder Recurrent Posterior Inferior Instability	5099-5003	20%	Right Shoulder Condition	5203	NSC	STR	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Right (Dominant) Shoulder Recurrent Posterior Inferior Instability.   According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI had a history of right shoulder dislocations and recurrent instability and had undergone right shoulder surgeries performed in 1998 and March 2003.  Following the March 2003 surgery he was returned to duty.  In 2004 he felt a pop with immediate pain in the right shoulder while performing pushups.  Orthopedic evaluation in August 2004 noted symptoms of instability while performing pushups but no recurrent dislocations were noted.  In October 2004 the CI underwent right shoulder surgery for a labral tear and tightening of the shoulder joint to improve stability.  A follow-up orthopedic examination 6 weeks after surgery noted there was minimal pain with -extreme rotation and he had been performing rotation exercises without pain.  However following further treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “other joint derangement…shoulder region” for PEB adjudication.  According to the MEB NARSUM evaluation on 20 January 2005, performed 3 months following shoulder surgery, the CI was “doing well.”  He had some transient shoulder pain after he caught his daughter from falling but recovered from that and was “progressing well.”  On examination, the CI’s right shoulder flexion was 180 degrees (normal 180) and abduction was 180 degrees (normal 180).  The examiner noted that instability testing was not performed due to the recent shoulder surgery.  The orthopedic surgeon noted the CI needed another 3-4 months of rehabilitation.  The CI did not complete a VA Compensation and Pension (C&P) examination proximate to the time of separation.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the shoulder condition 20%, coded 5099-5003 (analogous to degenerative arthritis), citing recurrent instability.  The VA did not grant service-connection for the CI’s right shoulder, citing no current evidence of a right shoulder condition (the VA subsequently granted a service connected rating of 20% for the right shoulder effective 14 May 2012).  There was no malunion with marked deformity of the humerus or frequent episodes of recurrent dislocation with guarding of all arm movements to warrant the next higher 30% rating under code 5202.  There was likewise no route to a higher rating for limitation of motion (5201), and no higher ratings available 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 20150602, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 21 Sep 16

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, 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:

		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN

						  
XXXXXXXXXXXXXXXXXXXX
Assistant General Counsel
					(Manpower & Reserve Affairs)