RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-02963
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20081230

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Field Radio Operator, medically separated for “right shoulder SLAP tear” with a disability rating of 10%.

CI CONTENTION: In addition to the right shoulder condition, the CI requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20081024	VARD - 20090121	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Shoulder SLAP Tear	5099-5003	10%	S/P SLAP Repair with Scars, Right Shoulder	
7805-5201	
20%	
20081112	
Right Shoulder Strain	Cat II					
Right Shoulder Impingement						
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Right Shoulder SLAP (Superior Labral Anterior Posterior) Tear. According to the service treatment record and MEB narrative summary (NARSUM), the left-handed CI underwent two right shoulder surgeries in 2007 for labral debridement and a third right shoulder surgery in February 2008 to repair a torn labrum and stabilize the shoulder. The CI continued to have shoulder pain, but declined further surgery.

The 5 September 2008 MEB NARSUM examination, 4 months prior to separation, noted complaints of continued right shoulder pain and weakness that prevented push-ups, pull-ups and strenuous lifting, and required adjustment of activities of daily living. Physical examination showed mild atrophy in the supraspinatus muscle, as well as muscle spasm and pain with initiation of motion. Shoulder range of motion (ROM) testing showed flexion of 180 degrees (normal 180) and abduction of 175 degrees (normal 180), with painful motion noted. Testing for shoulder impingement (Hawkins and Neer) was positive, as was testing for possible labral tear (O’Brien). There was no evidence of instability. During the 6 October 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported continued right shoulder pain. Physical examination revealed painful motion of the shoulder.

At the 12 November 2008 VA Compensation and Pension (C&P) examination, 2 months before separation, the CI reported constant right shoulder pain, rated 7/10 in severity, that impeded pushing, pulling, lifting and overhead reaching. Physical examination showed right shoulder tenderness and mild crepitus (popping or grinding noise or sensation on movement), with no swelling, redness or bruising. The examiner noted no weakness or instability, and recorded pain- limited flexion to 100 degrees and pain-limited abduction to 90 degrees without additional loss of motion with repetitive use. There was no muscle atrophy and the neurologic examination was normal.  Right shoulder X-rays were normal.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right shoulder at 10%, coded 5099-5003 (analogous to degenerative arthritis). The PEB also listed “right shoulder strain” and “right shoulder impingement” as Category II conditions (related to the primary unfitting diagnosis but not separately ratable). The panel agreed that the Category II conditions were part and parcel of the unfitting right shoulder condition and could not be separately rated without pyramiding (VARSD §4.14). The VA rated the right shoulder at 20%, coded 7805-5201 (scars causing limitation of arm motion), based on the C&P examination.

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 VA C&P examination, most proximate to separation, reflected this degree of limitation, which warranted a 20% rating. There was no fibrous union or nonunion of the humerus to justify a higher rating under the 5202 code (humerus, other impairment of), and no higher rating available 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 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	
Right Shoulder Superior Labral Anterior Posterior Tear	5201	20%	

The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20170328, w/atchs Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

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

IN REPLY REFER TO

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 29 Apr 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 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 office of the Deputy Commandant, Manpower and Reserve Affairs, for appropriate changes to your personnel records and notification to you upon completion.