RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01190
BRANCH OF SERVICE:  Marine Corps 	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, Aviation Ordnance Systems Technician, medically separated for “right shoulder AC [acromioclavicular] arthrosis status post revision mumford” with a disability rating of 20%.

CI CONTENTION:  The CI’s PEB rating did not include secondary conditions rated by the PEB.  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 on 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 - 20050310	VARD - 20050921	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Shoulder AC Arthrosis S/P Revision Mumford	5099-5003	20%	Right Shoulder AC Joint Separation S/P Reconstruction	5203	20%	20050301	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Shoulder AC Arthrosis S/P Revision Mumford Diagnosis.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right shoulder condition began in July 2002 when he dove while playing Frisbee and injured his right shoulder resulting in a grade II AC joint (ACJ) separation.  On 8 September 2003, the CI underwent an arthroscopic excision of the right distal clavicle; however, the CI continued to have symptoms. On 14 July 2004, a revision with excision of scar tissue and resection of osteophyte from the distal clavicle was performed.  Despite extensive physical therapy rehabilitation and several periods of limited duty (LIMDU), the right shoulder condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for MEB. The MEB forwarded “pain in joint, shoulder region” for PEB adjudication.  The MEB NARSUM examination on 28 January 2005, 5 months prior to separation, noted complaints of pain at the distal ends of his clavicle with strenuous activity and overhead motions.  The physical examination showed full range of motion (ROM) and normal strength.  There was negative testing for signs of impingement or instability.  The clinical examination were essentially normal.  X-rays showed that the resection of the collar bone had been adequate.  At the MEB examination (recorded on DD Forms 2807 and 2808) dated February 2005, 4 months prior to separation, the CI reported continued right shoulder pain with inability to do strenuous and overhead activity.  The physical examination showed full ROM and tenderness to palpation over the right ACJ.  Painful motion was not recorded.  X-rays on 1 March 2005, showed expected post-operative changes and a gradual widening of the ACJ of unclear significance.  

At the 1 March 2005 VA Compensation and Pension (C&P) evaluation, performed 3 months before separation, the CI reported continued right shoulder pain aggravated by use and overhead activity.  The physical exam showed post-operative changes and tenderness of the ACJ.  The scars were well healed.  The motor function was normal.  The ROM was full, but painful.  Six months after separation, the CI was seen in orthopedics.  His strength was 5+/5 and the ROM was full.  Neither painful motion nor instability was documented.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right shoulder condition 20%, coded 5099-5003 (analogous to arthritis, degenerative).  The VA also rated the right shoulder condition 20% coded 5203 (clavicle or scapula, impairment of), based on the VA C&P examination 3 months after separation, citing pain as the major component, limiting 50 percent of use of the right shoulder.  A 10% rating is supported for painful motion under the code 5203.  The Board found not route to a rating higher than the 20% rating assigned by the PEB.  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 20150612, 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 26 Apr 17

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and 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:

		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC 
		- XXXXXXXXXXXXXXXXXXX, former USMC 
		- XXXXXXXXXXXXXXXXXXX, former USMC 
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXX, former USMC