RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01791
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20051215

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Cryptologic Linguist, medically separated for “chronic right (dominant) shoulder pain” with a disability rating of 0%.

CI CONTENTION:  VA granted 30% effective 06 December 2005; should be medically retired.  The complete submission is at Exhibit A.

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(s) at the time of separation.  The panel 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 panel 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 - 20051027	VARD - 20060824	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right (Dominant) Shoulder Pain	5201	0%	Post-operative Residuals of Right Shoulder Injury	5201	30%	20060620	
Gastroparesis	Not Unfitting	Gastroparesis	7399-7346	10%	20060620	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  70%	

ANALYSIS SUMMARY:

Right Shoulder.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right shoulder condition began in November 2002 after tripping during physical training.  Radiographic imaging revealed a sub-chondral cyst, rotator cuff tear, and impingement within the right shoulder.  In October 2004, the CI underwent arthroscopic decompression and ligament repair of the right shoulder.

During the 21 April 2005 Physical Therapy evaluation, 8 months before separation, the CI reported right shoulder pain with slight numbness and tingling in the pinky and right fingers.  Physical examination revealed range of motion (ROM) of flexion and abduction to 100 degrees (both normal 180); painful motion was not addressed.  At the 16 May 2005 MEB NARSUM evaluation, 7 months before separation, the CI reported continued right shoulder pain.  Physical examination revealed ROM of flexion to 105 degrees (normal 180) and abduction to 103 degrees; painful motion was not addressed.  

During the 20 June 2006 VA Compensation and Pension (C&P) examination, performed 6 months after separation, the CI reported continued right shoulder pain with numbness in the right 4th and 5th fingers.  Physical therapy documented ROM of flexion to 90 degrees and abduction to 80 degrees with painful motion.  There was additional limitation of abduction to 70 degrees with repetitive use.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right shoulder 0%, coded 5201 (arm, limitation of motion), citing active abduction to 104 degrees.  The VA rated the right shoulder condition 30%, also coded 5201, based on the C&P examination 6 months after separation, citing arm limited motion midway between side and shoulder level.  The VASRD §4.71a threshold for rating ROM impairment code 5201, (arm limitation of motion) is “at shoulder level” (approximately 90 degrees from the side).  The panel agreed that the MEB NARSUM and C&P ROM examinations, proximate to separation, support a 20% rating but no higher.  

There was no malunion with marked deformity or frequent episodes of recurrent dislocation of the humerus to justify a higher rating under the 5202 code (humerus, other impairment of), and no higher ratings available under the 5203 code (clavicle or scapula, impairment).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 20% for the right shoulder condition, coded 5201.

BOARD FINDINGS:  In the matter of the chronic right (dominate) shoulder pain condition, the panel unanimously recommends a disability rating of 20%, coded 5201 IAW VASRD §4.71a.  In the matter of the contended gastroparesis condition, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  The panel recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Right (Dominant) Shoulder Pain	5201	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150623, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170009077, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	
Enclosure