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DEPARTMENT OF THE NAVY
SECRETARY OF THE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD DC 20374-5023

INREPLYR(F[RTO

1850
CORB:003
27 Feb 20

From:
To:

Director, Secretary of the Navy Council of Review Boards
PD-2017-02557

Subj:	PHYSICAL DISABILITY BOARD OF REVIEW (PDBR)
Ref:	(a) DoDI 6040.44
(b) PDBR ltr of 29 Oct 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded   its
recommendation to the Department of the Navy for appropriate action.
2.	On 21 February 2020, the Assistant General Counsel of the Navy (Manpower & Reserve  Affairs)  took  action  in  your  case by    accepting  the recommendation of the PDBR.	Accordingly,  your  records  will  be corrected  to reflect an increase in the disability rating awarded by the Department of the Navy Physical Evaluation Board (PEB) from 10% to 20% without re-characterization of your discharge.
3.	For your information, since all disability ratings from 0% to 20% qualify for disability severance pay, the above stated increase will not result in your entitlement to additional compensation.

4.	The Assistant Secretary's determination, which represents final action  in  your case by the Department of the Navy, has been forwarded to the Deputy Commandant, Manpower and Reserve Affairs,  for appropriate  changes to  your personnel  records  and notification  to  you  upon completion.

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-02557 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20060915

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Assault Amphibious Vehicle Repairer/Technician, medically separated for “persistent pain to the right shoulder” with a disability rating of 10%.

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 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 - 20060713	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Persistent Pain to the Right Shoulder	5299-5003	10%	No VA Examination Proximate to Separation in Evidence	
Right Posterior Subluxation of [the] Glenohumeral Joint	Cat II		
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Persistent Pain to the Right Shoulder. According to the service treatment record and the MEB narrative summary (NARSUM), the left hand dominant CI underwent a right shoulder surgery in May 2005 with labral repair and capsular plication for stability. An orthopedic clinic visit in April 2006 showed flexion and abduction of 180 degrees (normal), but apprehension and relocation tests were positive. In May 2006, orthopedics noted atrophy of the right shoulder muscles. Range of motion (ROM) testing was painful and limited due to guarding with abduction of 130 degrees and flexion of 140 degrees.  The CI denied dislocations since surgery.

The 3 May 2006 MEB NARSUM examination, 4 months prior to separation, noted complaints of significant pain as well as instability with forward flexion. A ROM study showed 140 degrees of flexion without dislocation, but the CI was extremely apprehensive to the maneuver. Abduction was also 140 degrees with significant guarding from the 100-140 degree arc. There was no evidence of instability. During the 21 June 2006 MEB examination (recorded on DD Forms 2807-

1 and 2808), 3 months prior to separation, the CI reported pain in the right shoulder. The ROM study showed 90 degrees of flexion, but internal rotation, external rotation and extension were normal.  There was no VA examination proximate to separation in evidence.

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 (degenerative arthritis). The Navy PEB also listed “right posterior subluxation of [the] glenohumeral joint” as a related Category II condition (contributed to the primary unfitting condition, but is not separately ratable). The panel agreed that any impairment from the Category II condition was properly subsumed under the overall rating for the right shoulder condition to avoid pyramiding (§4.14).

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 examination reflected this degree of limitation. The panel considered other VASRD shoulder and analogous codes, but all were less applicable and/or not advantageous for rating. After due deliberation, considering all 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	
Persistent Pain to the Right Shoulder	5201	20%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170312, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

2	PD-2017-02557