RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01797
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060328

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E6, Chemical Operations Specialist, medically separated for “chronic right shoulder pain,” with a disability rating of 10%.

CI CONTENTION:  The CI contends for his unfitting shoulder condition and that the condition continue to worsen and negatively impact daily activities.  The CI’s 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 - 20060202	VARD - 20060105	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Shoulder Pain…	5003	10%	Right Shoulder Labral Tear, S/P Surgical Repair	5201	20%	20060105	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right (Non-dominant) Shoulder Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent right shoulder surgeries in October 2003 (arthroscopy), February 2004 (Bankart repair) and August 2004 (acromioplasty) for abduction and external rotation injury (labral tear).  Following surgery further treatment did not result in improvement sufficient to allow unrestricted duty.  

The 9 November 2005 MEB NARSUM examination, 5 months prior to separation, noted improved stability, but minimal pain improvement since the August 2004 surgery.  The CI reported increased pain with loading of the shoulder joints and decreased external rotation and abduction.  The CI reported difficulty performing activities of daily living.  Shoulder dislocations were not reported.  Physical examination showed no evidence of instability.  Right shoulder abduction was 120 degrees (normal 180 degrees).  

At the 5 January 2006 VA Compensation and Pension examination, performed 3 months before separation, the CI reported pain in his right shoulder that occurred about half the time during a month and the other half “it was just a dull ache.”  He had no incapacitating episodes and did not miss any work as a result of his injury.  He was not currently taking any medicine for the pain and did not use any assistive devices.  Physical examination showed mild atrophy of the deltoid and biceps muscle of the CI’s right upper extremity.  Right shoulder flexion was 90 degrees (normal 180 degrees) and abduction was 90 degrees after repetitive motion.  There was tenderness and painful motion.  The examiner noted that the CI was left-hand dominant.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating under the 5003 code (degenerative arthritis), citing arthritis with loss of joint motion.  The VA assigned a 20% rating using the 5201 code (limitation of motion of arm) for limited range of motion (at shoulder level).  

The VASRD §4.71a threshold for rating for ROM impairment (code 5201, arm limitation of motion) is “at shoulder level” (approximately 90 degrees from the side), and the examinations in evidence demonstrated motion above this level.  Although there was insufficient limitation of motion to support a rating under the 5201 code, panel 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 panel 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 panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, 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 20150630, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170009081, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.

Sincerely,					      
						      					
Enclosure