RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00879
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20040930

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Track Vehicle Repairer, medically separated for “chronic left shoulder pain” with a disability rating of 0%.

CI CONTENTION:  Current condition supports a higher rating.  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 progression or complications of service-connected conditions after separation.  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 - 20040815	VARD - 20041115	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Shoulder Pain	5099-5003	0%	Anterior Inferior Glenohumeral Ligament Tear with Instability of Left Shoulder	5202	20%	20040930	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:

Chronic Left Shoulder Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left (non-dominant) shoulder condition began in May 2001 after felling on an outstretched left arm and then onto the left shoulder.  Radiographic imaging (MRI) performed in June 2003 revealed a torn left shoulder ligament.  At the orthopedic clinic appointment on 5 May 2004, 5 months prior to separation, the CI reported continued left shoulder pain with instability complaints of popping, clicking, and feeling like the shoulder was coming out of place.  Physical examination revealed a full range of motion (ROM) with popping and clicking during abduction, internal and external rotation.  Maneuvering tests for joint instability were negative.  Upper extremity remained neurologically intact.  During the 20 July 2004 MEB NARSUM evaluation, 2 months prior to separation, the CI reported daily left shoulder pain that increased with most activities, and chronic dislocations of the left shoulder with minimal effort.  Physical examination revealed full active ROM with painful motion.  A positive apprehension test indicated anterior instability of the joint.  Upper extremity remained neurologically intact.

At the 30 September 2004 VA Compensation and Pension (C&P) examination, the day of separation, physical examination revealed ROM of normal flexion and abduction to 90 degrees (normal 180) with painful motion.  The examiner opined “overall impression is chronic instability with chronic recurrent dislocations, left shoulder (non-dominant).”  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left shoulder condition 0%, analogously coded 5003 (degenerative arthritis), citing abduction at 145 degrees.  The VA rated the left shoulder condition 20%, coded 5202 (humerus, other impairment), based on the C&P examination on the same day as separation, citing episodes of dislocation of the scapula-humeral joint with guarding of arm movements at the shoulder level.

Panel members agreed that a 20% impairment rating was justified for limited ROM of the shoulder in abduction to 90 degrees (at shoulder level) IAW VASRD criteria as seen on the day of separation.  Members also considered the subjective complaints of dislocations, and determined that neither infrequent nor frequent episodes of dislocations rated greater than the limited ROM at 20%.  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 left shoulder condition, coded 5202.

BOARD FINDINGS:  In the matter of the chronic left shoulder pain condition, the panel unanimously recommends a disability rating of 20%, coded 5202 IAW VASRD §4.71a.  There are no other conditions within the panel’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 Left Shoulder Pain	5202	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160919, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170017220, 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