RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02008
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051207

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Human Resource Specialist, medically separated for “chronic right shoulder pain and instability” with a disability rating of 20%.   

CI CONTENTION:  Shoulder condition has worsened and negatively impacts daily activities.  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 - 20051014	VARD - 20060815	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Shoulder Pain and Instability	5202	20%	Capsulitis of the Right Shoulder 	5202	20%	20060610	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Right Shoulder Pain and Instability.  According to the service treatment record and the MEB narrative summary (NARSUM), the right-hand dominant CI underwent two right shoulder surgeries prior to entering the Service in January 2003.  He experienced re-injury with dislocations of his glenohumeral joint on several occasions starting in September 2003.  On each occasion, he was able to successfully relocate his shoulder.  Radiographic studies in February 2005 showed a stable shoulder without evidence of interval re-injury or labral tear. 

During the 9 June 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported tingling in his right hand and fingers.  Range of motion (ROM) testing of the right shoulder showed abduction of less than 100 degrees (normal 180).  There was no flexion measurement reported, but the apprehension test was positive.  

The 31 August 2005 MEB NARSUM examination, 3 months prior to separation, noted complaints of constant pain of the posterior aspect of the right shoulder radiating to the right arm.  Physical examination showed a stable right shoulder.  The goniometric ROM evaluation, after repetitive motion, showed right shoulder flexion of 100 degrees (normal 180) and abduction of 84 degrees.  

At the 10 June 2006 VA Compensation and Pension (C&P) examination, 6 months after separation, the CI reported a daily aching, nagging pain in the superior aspect of the right shoulder and significant stiffness and weakness.  The examiner noted the CI had a history of instability or giving way of his shoulder, but had neither in the last year.  Also noted was the history of recurrent subluxations, but none in the last year.  The CI used no aids, braces or other significant devices for his shoulder.  Physical examination showed no swelling or atrophy.  Right shoulder active flexion measured with a goniometer was 110 degrees and abduction was 90 degrees after repetitive motion.  There was tenderness and painful motion.  The CI had a negative impingement sign, and there was no evidence of subluxation or dislocation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right shoulder condition 20%, coded 5202 (humerus, other impairment of), citing infrequent episodes and guarding of movement at shoulder level.  The VA also rated the right shoulder condition 20%, coded 5202 (humerus, other impairment of), based on the C&P examination, citing infrequent episodes of dislocation of the scapulohumeral joint with guarding of arm movements only at shoulder level.  

There was no evidence of frequent episodes of recurrent dislocation with guarding of all arm movements, and no malunion with marked deformity of the humerus to warrant the next higher 30% rating under code 5202.  Alternative rating under code 5201 (arm, limitation of motion of) would be no greater than 20% as arm motion did not more nearly approximate limitation midway between side and shoulder level (approximately 45 degrees), and no higher rating is available under the 5203 code (clavicle or scapula, impairment of).  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.  

BOARD FINDINGS:  In the matter of the right shoulder 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 20170222, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180015101, 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