RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02912
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080320

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E2, Petroleum Supply Specialist, medically separated for “left (non-dominant) acromio-clavicular (AC) joint separation” with a disability rating of 10%.   

CI CONTENTION:  “More than one condition should have been considered.”  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 USPDA - 20080503	VARD - 20081121	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left (Non-Dominant) AC Joint Separation	5099-5003	10%	Residual, Status Post Left Shoulder Separation	5299-5201	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Left (Non-Dominant) AC Joint Separation.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s left shoulder condition began in February 2007 after being involved in a motorcycle accident where he sustained a grade III AC joint separation.  The condition did not improve with conservative treatment.  A CT scan on 20 June 2007, showed a persistent AC joint separation and some dystrophic calcifications on the lateral aspect of the clavicle.  
The 17 December 2007 MEB NARSUM examination, 3 months prior to separation, noted complaints of popping in the left shoulder with soreness rated 2/10.  Physical examination showed forward flexion to 180 degrees (normal) with pain in the last 20 degrees and abduction to 180 degrees (normal) with pain in the last 20 degrees.  Tenderness was noted over the left AC joint, but there was no visual deformity.  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 left AC joint separation condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing full range of motion with loss of function.  The VA rated the residuals, status post left shoulder separation condition 0%, analogously coded 5299-5201 (arm, limitation of motion), based on the STR examination, citing no documentation to support the arm motion was limited at shoulder level.

Although there was no 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) coded 5099-5003.  There was no malunion or recurrent dislocation of the humerus to justify a rating under the 5202 code (humerus, other impairment); and no nonunion with loose movement of the clavicle to warrant the next higher 20% rating 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 left AC joint separation condition.   

BOARD FINDINGS:  In the matter of the left acromio-clavicular joint condition and IAW VASRD §4.71, 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 20170327, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20190008794, 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.

A copy of this decision has been provided to the counsel you listed on your application,