RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00627
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20081128

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E6, Aerospace Maintenance Craftsman, medically separated for “left shoulder pain” with a disability rating of 20%.

CI CONTENTION:  No specific contention was made.  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 Medical Evaluation Board (MEB), but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.

RATING COMPARISON:

SERVICE PEB - 20081009	VARD - 20090610	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Shoulder Pain	5201	20%	Left Shoulder Status Post Bankart Repair	5201	10%	20090407	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Left Shoulder Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI originally injured his non-dominant left shoulder after slipping on a bathroom floor.  He underwent left shoulder surgery for a superior labral tear from anterior to posterior, and Bankart lesion in February 2003, and a repeat arthroscopy in January 2007 for a Bankart repair revision and rotator cuff interval closure.  A third surgery was performed in September 2007 for capsulotomy (stiffness) and lysis of adhesions (remove scar tissue).

At a primary care clinic appointment on 11 July 2008, 4 months prior to separation, the CI reported left shoulder pain, especially with heavy lifting, and that his shoulder felt stable but weak.  Physical examination showed range of motion (ROM) of flexion to 160 degrees (normal 180) and abduction to 165 degrees (normal 180).  Impingement signs were negative and there was no weakness with rotator cuff resistance.  

The 23 July 2008 MEB NARSUM examination, 4 months prior to separation, noted CI complaints of constant left shoulder pain.  Physical examination revealed abduction pain above 90 degrees (not quantified), and decreased abduction strength compared to the right.  A left shoulder MRI on 14 August 2008, 3 months prior to separation, indicated that the superior and anterior labrum and rotator cuff appeared intact with no subacromial/subdeltoid bursa fluid, but mild acromioclavicular joint degenerative changes were present.

At the 7 April 2009 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported left shoulder pain.  Physical examination showed upper extremity strength at 4/5 and left shoulder tenderness without swelling, effusion or laxity.  Flexion was to 160 degrees and abduction to 178 degrees; painful motion was absent.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left shoulder condition 20%, coded 5201 (arm, limitation of motion).  The VA rated the left shoulder condition 10%, also coded 5201, based on the C&P examination, citing reduced left shoulder strength.  Members agreed there was no left shoulder evidence of limitation of motion (5201), fibrous union or nonunion of the humerus (5202), or clavicle or scapula impairment (5203) to support a rating higher than the 20% rating adjudicated by the PEB.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the left shoulder condition.

BOARD FINDINGS:  In the matter of the left shoulder pain condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends 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 20170214, w/atchs  
Exhibit B.  Service Treatment Record  
Exhibit C.  Department of Veterans Affairs Record  

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD 20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-00627.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						Sincerely,

								XXXXXXXXXXXXXXXXXX
								Director
								Air Force Review Boards Agency

Attachment:
Record of Proceedings