RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX 	CASE:  PD-2016-00846
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20040326

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Multichannel Transmission Systems Operator and Maintainer, medically separated for “right acromioclavicular (AC) joint injury” with a disability rating of 10%.  

CI CONTENTION:  “Review all conditions.”  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 - 20031113	VARD - 20040723	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right AC Joint 	5099-5003	10%	Residual AC Joint Strain with Headaches	5203	10%	20040517	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Right Acromioclavicular (AC) Joint.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was right-handed.  His right shoulder condition began in August 2002 after exercising on a machine that broke while in use.  X-rays were essentially normal and magnetic resonance imaging (MRI) of the right AC joint changes were interpreted by orthopedics as right AC Grade I separation with arthrosis.  No surgery was recommended.  The 16 October 2003 MEB NARSUM examination, 5 months before separation, noted complaints of chronic right shoulder pain.  Physical examination showed mild atrophy of the deltoid area and tenderness of the AC joint.  Goniometric range of motion (ROM) showed flexion to 160 degrees (normal 180) and abduction to 120 degrees (normal 180) with painful motion.  Shoulder subluxation and dislocation were not addressed.  
At the 17 May 2004 VA Compensation and Pension (C&P) evaluation, 2 months after separation, the CI reported constant right AC joint pain.  X-rays showed normal to borderline mild widening of the right AC joint.  Physical examination showed ROM of flexion and abduction to 165 degrees with painful motion.  Strength was symmetric.  Shoulder subluxation and dislocation were not addressed.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right AC joint condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing some loss of joint motion.  The VA also rated the right AC joint condition 10%, coded 5203, (clavicle or scapular, impairment), based on the C&P examination 2 months after separation, citing pain-limited motion.  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 STR and VA examinations in evidence demonstrated motion above this level.  Although there was no limitation of motion to support a rating under the 5201 code, the panel 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 AC joint condition.  

BOARD FINDINGS:  In the matter of the right acromioclavicular joint condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160913, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170017174 , XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX  

Dear XXXXXXXXXXXXXXXXXXX:

	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