RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-02914
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20050615

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Metal Worker medically separated for “right sternoclavicular joint injury” with a disability rating of 0%.

CI CONTENTION: “I was medically separated from the USMC even though I did not want to due to injury and was awarded 0% disability.”  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 - 20050324	VARD – NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Sternoclavicular Joint Injury	5299-5003	0%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Right Sternoclavicular Joint Injury. According to the service treatment record and MEB narrative summary (NARSUM), the right-handed CI’s right sternoclavicular (SC) joint injury occurred during the summer of 2003, while deployed, when he was thrown from a tactical vehicle. The CI completed his deployment and subsequently re-injured the right SC joint during martial arts training. A CT in June 2004 showed mild anterior and superior subluxation of the right SC joint with no evidence of associated fractures. Orthopedics diagnosed anterior SC joint subluxation, but surgery was deferred.

At the 19 January 2005 orthopedic subspecialist examination, 5 months prior to separation, the CI complained of right shoulder pain and instability. Physical examination showed no obvious right clavicle deformity. There was pain over the right SC joint with elevation of the shoulder above 120 degrees (normal 180). There was palpable crepitus when the arm was hyper-flexed or horizontally abducted. There was no evidence of instability of the medial clavicle, and rotator cuff strength was excellent. The examiner stated that symptoms were minimal to moderate and significantly slowed the CI.

The 8 February 2005 MEB NARSUM examination, 4 months prior to separation, noted complaints of right anterior clavicular pain. Physical examination revealed right shoulder tenderness and guarding of movement with mild pain on elevation of the shoulder and positive impingement with passive motion at 30 degrees. Right shoulder strength was 2/5 with elevation. There was no gross deformity and grip and rotator cuff strength were intact. 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 0%, analogously coded 5299-5003 (degenerative arthritis). 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 examination in evidence demonstrated motion above that level. There was no malunion or recurrent dislocation of the humerus to justify a rating under the 5202 code (humerus, other impairment of). However, the panel agreed that rating under code 5203 (clavicle or scapula, impairment of) was predominant and given the impingement signs, orthopedic diagnosis of true subluxation, and crepitus with weakness depicted at the NARSUM examination, the CI’s disability picture more nearly represented the 20% criteria for dislocation or nonunion with loose movement of the clavicle to warrant the 20% (highest available) rating under code 5203. 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 SC joint condition, coded 5299-5203.

BOARD FINDINGS: In the matter of the right shoulder condition, the panel recommends a disability rating of 20%, coded 5299-5203 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	
Right Sternoclavicular Joint Injury	5299-5203	20%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170421, w/atchs Exhibit B.  Service Treatment Record

Exhibit C.  Department of Veterans Affairs Record

2	PD-2017-02914

IN REPLY REFER TO

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

									                             1850
									                             CORB:003
                                                                                                                                                                           9 Jun 20 

From:  Director, Secretary of the Navy Council of Review Boards

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) 

Ref:   (a) DoDI 6040.44
         (b) PDBR ltr of 5 May 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 4 June 2020, the Assistant Secretary 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 0% 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 office of the Deputy Commandant, Manpower and Reserve Affairs, for appropriate changes to your personnel records and notification to you upon completion.