RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXX	CASE: PD-2017-02750
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20080612

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

CI CONTENTION:  No specific contention was made. 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 - 20080215	VARD - 20080714	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Shoulder Pain	5099-5003	10%	Chronic Right Shoulder Pain	5299-5203	10%	20080514	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Right Shoulder Pain. According to the service treatment record and MEB narrative summary (NARSUM), the right-handed CI’s right shoulder condition began in January 2005 after lifting heavy gear into trucks. At the time of the orthopedic clinic appointment on 27 September 2007, 8 months prior to separation, the CI reported pain with raising the right arm above shoulder level, but denied feelings of shoulder joint instability. On examination, there was tenderness at the bicipital groove, but Speed’s test was negative. There was no pain elicited during impingement testing and no instability. The 22 January 2008 MEB NARSUM examination, 5 months prior to separation, noted complaints of right shoulder pain, localized to the right sternoclavicular joint but sometimes radiating into the posterior neck and head, causing occasional headaches. Average daily pain was 5/10 and at least twice a month she experienced 8/10 pain.      The right

shoulder range of motion (ROM) evaluation showed flexion of 175 degrees (normal 180) and abduction of 180 degrees (normal) with painful motion. X-rays revealed no evidence of fracture in the right clavicle.

At the 14 May 2008 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported difficulty with reaching and lifting with the right arm and occasionally noticed swelling, redness and tenderness in the medial part of the clavicle. Physical examination showed mild swelling and tenderness at the medial end of the clavicle near the sternoclavicular junction. There was no warmth, erythema, loose motion, shortening, drainage or heat. Right shoulder ROM testing showed flexion of 170 degrees and abduction of 160 degrees with pain.

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 degenerative arthritis with slight loss of joint motion. The VA also rated the right shoulder condition 10%, analogously coded 5203 (clavicle or scapula, impairment of), based on the C&P examination, citing pain on motion.

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 examinations in evidence demonstrated motion above this level. Although there was insufficient limitation of motion to support a rating under the 5201 code, panel members agreed that a 10% rating was justified with application of VASRD §4.59 (painful motion). There was no malunion or recurrent dislocation of the humerus to justify a rating under the 5202 code (humerus, other impairment of); and no nonunion with loose movement of the clavicle to warrant the next higher 20% rating 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 20170426, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20190007125, XXXXXXXXXXXXXXXXXX 

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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.

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