RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00730
BRANCH OF SERVICE:  army	SEPARATION DATE:  20061013

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Watercraft Engineer, medically separated for “chronic right shoulder pain” with a disability rating of 20%.

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 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 - 20060829	VARD - 20070411	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Rt Shoulder Pain	5201	20%	Rt Shoulder with Degenerative Joint Disease	5010	10%	20070124	
Rt Knee Pain	Not Unfitting	Rt Knee with Patellofemoral Syndrome	5024	0%	20070124	
Hearing Loss Rt Ear	Not Unfitting	Rt Ear Tinnitus	6260	10%	20070124	
		Bilateral Hearing Loss	6100	0%	20070124	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  50%	

ANALYSIS SUMMARY:

Chronic Right Shoulder Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right shoulder surgery for an impingement in October 2005.  During an orthopedics evaluation on 19 January 2006, 9 months before separation, right shoulder abduction measurement was less than 90 degrees (normal 180); painful motion was not addressed.  Right shoulder X-rays showed the lateral clavicle not significantly resected, and some spotty bone demineralization around the area.  At a physical therapy evaluation on 27 April 2006, 6 months prior to separation, right shoulder flexion was 105 degrees (normal 180) and abduction was 90 degrees; painful motion was not addressed.  The 7 July 2006 MEB NARSUM examination, 3 months prior to separation, noted complaints of right shoulder pain.  Activities of daily living were severely limited and she was unable to perform solider duties.  Physical examination showed right shoulder flexion and abduction to 90 degrees; painful motion was not addressed.

At the 24 January 2007 VA Compensation and Pension (C&P) general examination, 3 months after separation, the CI reported constant right shoulder pain which was aggravated by physical activity and relieved with pain medication.  Physical examination showed no right shoulder tenderness, guarding, fracture, deformity, edema, effusion, heat, and redness, subluxation, locking pain, crepitus or ankylosis.  Flexion and abduction were each 180 degrees with no loss of motion with repetitive motion.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right shoulder condition 20%, coded 5201 (arm, limitation of motion), citing limitation of motion.  The VA rated the right shoulder condition 10%, coded 5010 (arthritis, due to trauma), based on the C&P general examination, citing painful motion.  The VASRD §4.71a threshold for rating ROM impairment (code 5201, arm limitation of motion) at 20% is “at shoulder level” (approximately 90 degrees from the side), and the examinations in evidence demonstrated motion limited to this level.  The next higher 30% rating for the dominant arm requires motion limited to “midway between side and shoulder level.”

The panel agreed there was no limitation of motion of the right shoulder to support a rating higher than the 20% adjudicated by the PEB under diagnostic code 5201 (arm, limitation of motion).  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), and no nonunion or malunion of the clavicle or scapula to warrant any rating under the 5203 code (clavicle or scapula, impairment).  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 right shoulder condition.

Contended PEB Conditions:  Right Knee Pain, Right Ear Hearing Loss.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  Although both conditions were profiled L2 and H2, respectfully, the conditions were not implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that either of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions so no additional disability ratings are recommended.

BOARD FINDINGS:  In the matter of the right shoulder condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended right knee pain and right ear hearing loss conditions, the panel recommends no change from the PEB determinations as not unfitting.  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 20170221, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record  

AR20180005733, 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