RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-00832
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20070531

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Tracked Vehicle Mechanic, medically separated for “chronic pain right shoulder” with a disability rating of 10%.

CI CONTENTION:  Received a higher rating from the VA.  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 - 20070330	VARD - 20070605	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain Right Shoulder	5099-5003	10%	Residuals of Right Shoulder Arthroscopic	5201	20%	20061218	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Chronic Pain Right Shoulder.  According to the service treatment record and MEB narrative summary (NARSUM), the right-handed CI underwent right shoulder arthroscopy with removal of a loose body in December 2005 and reconstruction surgery in March 2006 for multidirectional instability.

The 18 December 2006 VA Compensation and Pension (C&P) examination, 5 months before separation, documented complaints of right shoulder pain, weakness, lack of endurance, locking and fatigability when used over 30 minutes.  There were signs of weakness, abnormal movement and guarding of movement.  The range of motion (ROM) was painful with flexion of 85 degrees (normal 180) and abduction of 80 degrees (normal 180), with no additional limitation on repetition.  X-rays were negative.  

The 13 March 2007 MEB NARSUM examination, 2 months prior to separation, noted complaints of right shoulder pain and lifting limitations.  Physical examination showed positive impingement signs, painful motion and laxity.  Active ROM was flexion of 105 degrees and abduction to 90 degrees.  There was slight weakness (4+/5) on abduction and internal and external rotation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right shoulder condition 10%, analogously coded 5099-5003 (arthritis, degenerative), citing the US Army Physical Disability Agency pain policy.  The VA rated the right shoulder condition 20%, coded 5201 (arm, limitation of motion), based on the C&P examination, citing arm motion limited at shoulder level.

The VASRD §4.71a threshold for rating for ROM impairment (code 5201) is “at shoulder level” (approximately 90 degrees from the side), and the MEB NARSUM and VA examinations reflected this degree of limitation.  There was no fibrous union or nonunion of the humerus to justify a higher rating under the 5202 code (humerus, other impairment) and no higher rating available under the 5203 code (clavicle or scapula, impairment).  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 right shoulder condition, coded 5201.

BOARD FINDINGS:  In the matter of the right shoulder condition, the panel recommends a disability rating of 20%, coded 5201 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Chronic Pain Right Shoulder 	5201	20%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20170223, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180007711, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

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