RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-02178
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081022

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Petroleum Supply Specialist, medically separated for “left (non-dominant) shoulder limitation of motion” with a disability rating of 20%. 

CI CONTENTION:  The shoulder condition continues to worsen.  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 - 20080715	VARD - 20090328	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Shoulder Limitation of Motion	5024-5201	20%	Left Shoulder Tendinitis	5202-5201	20%	20090310	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20% 	

ANALYSIS SUMMARY:  

Left Shoulder Limitation of Motion.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent left shoulder surgery to repair a torn labrum in July 2007.  Despite physical therapy (PT) and activity restrictions, pain and the feeling of instability remained.  An MRI performed in May 2007 noted tendinosis about the left shoulder with evidence of a “tiny” tear in the labrum.  On 3 June 2008, PT measurement of left shoulder range of motion (ROM) documented abduction of 135 degrees (normal 180) and flexion of 155 degrees (normal 180).  Painful motion was present.

The 13 June 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of constant left shoulder pain which interfered with lifting, carrying fuel hoses and other heavy equipment.  Due to the presence of “severe shoulder pain” during this examination, repeat ROM measurements were noted as flexion to 90 degrees with 8 degrees further decrease upon repetition.   Abduction was measured at 90 degrees with 2 degrees increase upon repetition.  Painful motion was present.  

At the 10 March 2009 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI reported 8/10 pain in the left shoulder, neck and shoulder blade area with symptoms of weakness, stiffness, give way, lack of endurance, fatigability, and loud popping.  He denied swelling, heat, redness, locking, or dislocation.  His PE showed no signs of edema, effusion, weakness, tenderness, redness, heat, subluxation, or guarding of movement.  Left shoulder ROM evaluation documented flexion to 120 degrees and abduction to 90 degrees with painful motion.  There was no additional change in ROM upon repetition.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left shoulder condition 20%, dual coded 5024-5201 (tenosynovitis causing limitation of motion), citing abduction and flexion of 90 degrees.  The VA also rated the left shoulder condition 20%, dual coded 5202-5201 (humerus impairment causing limitation of motion), based on the C&P examination, citing limitation of arm motion at shoulder level.  Panel members agreed that the measured ROM of the left (non-dominant) shoulder in either pre- or post-service examinations would not support a rating higher than the PEB’s 20%.  There was no clinical evidence of ankylosis or nonunion/malunion of any component of the shoulder girdle.  Therefore, 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’s adjudication for the left shoulder condition.

BOARD FINDINGS:  In the matter of the left 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 20170301, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180015057, 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