From: To:

IN REPLY REFER TO

1850
CORB:003
12 Feb 20

Director, Secretary of the Navy Council of Review Boards 
PD-2017-02104

Subj: Ref:

PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)

(a) DoDI 6040.44
(b)	PDBR ltr dtd 18 Feb 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy of 15 October 2019 for appropriate  action.

2.	On 31 January 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02104 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20070430

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

CI CONTENTION: “Right shoulder surgery. I have had 3 surgeries on the same shoulder which has kept me out of work for 18 months.”  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 - 20070116	VARD - 20080517	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Traumatic Arthritis of the Right Shoulder…	5201	20%	Right Shoulder Impingement Syndrome…	5099-5024	10%	20070612	
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 60%	

ANALYSIS SUMMARY:

Right (Non-Dominant) Shoulder Arthritis. According to the service treatment record and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent right shoulder surgery in June 2005 for arthroscopic Bankart-type shoulder repair. During the 26 October 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported chronic right shoulder pain. Physical examination revealed painful range of motion (ROM) with no subluxation. The 7 November 2006 MEB NARSUM examination, a week and a half later, noted complaints of right shoulder pain (6/10).  Physical examination showed  tenderness

on the right posterior glenohumeral joint area. Right shoulder ROM showed flexion of 125 degrees (normal 180) and abduction of 90 degrees (normal 180).

At the 12 June 2007 VA Compensation and Pension (C&P) examination, one month after separation, the CI reported right shoulder discomfort aggravated by lifting heavy weight and doing above shoulder activity. Physical examination showed a well-healed scar on the right shoulder area. The shoulders could not be dislocated or subluxated. Right shoulder ROM showed flexion and abduction of 170 degrees, respectively. Painful motion was noted and there was no loss of motion on repetitive movement.

X-rays of the right shoulder on 29 April 2008, 12 months after separation, revealed the bone and joint structures appeared intact with no evidence of arthritic disease or other significant abnormality. A small density seen within the medial aspect of the proximal humeral metaphysis was consistent with a bone island. At the time of the orthopedic clinic appointment on the same day, the CI reported right shoulder pain. On examination he was able to forward elevate to 130 degrees. Strength was 4/5 with forward elevation and 5/5 with external rotation. There was no AC joint tenderness.

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 of). The VA rated the right shoulder condition 10%, analogously coded 5024 (tenosynovitis), based on the C&P examination, citing painful or limited motion of a major joint. The VASRD §4.71a threshold for rating for ROM impairment (code 5201, arm limitation of motion) is “at shoulder level” (approximately 90 degrees from the side), and the MEB NARSUM examination in evidence demonstrated motion limited to this level. The highest 30% rating for a non-dominant arm requires motion limited to “25 degrees from side,” but examinations did not reflect 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 ratings available 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.

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 20170706, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

	PD-2017-02104