RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:	CASE: PD-2017-02971
BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20061031

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Field Wireman and Motor Vehicle Operator, medically separated for “left shoulder pain” with a disability rating of 10%.

CI CONTENTION: I was unable to continue work in several trades due to inability to work in small spaces. 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 - 20060922	VARD - 20070710	
		
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Shoulder Pain	5299-5003	10%	Left Shoulder Residuals	5299-5201	NSC	20070312	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Left Shoulder Pain with Subluxation. According to the MEB narrative summary (NARSUM) and service treatment record, the right-handed CI’s left shoulder condition began in 2003 after a tactical vehicle roll-over while deployed. Left shoulder X-ray showed no bony abnormalities. During the 27 July 2006 orthopedic examination, the CI complained of left shoulder pain and frequent subluxations with pulling movements or pushups. Bilateral shoulder appearance was normal, and range of motion (ROM) testing showed flexion and abduction of 180 degrees (normal). There was no subluxation, laxity, weakness or instability noted. The left shoulder was tender with painful motion and had signs of impingement, but no sensory or motor abnormalities were noted. The diagnoses of rotator cuff and bicipital tendonitis was made.

At the 25 August 2006 MEB NARSUM examination, 3 month prior to separation, the CI reported left shoulder pain, weakness and popping with ROM at the acromioclavicular joint (AC joint). He also reported left shoulder instability, but denied any history of dislocation or subluxation. Physical examination revealed left AC joint tenderness and 4/5 left supraspinatus muscle strength. The left shoulder anterior and posterior laxity was 1+ (mild), with no sulcus sign present. There was no evidence of generalized ligamentous laxity and sensation was intact. Left shoulder flexion was 180 degrees and abduction was 175 degrees, with painful motion.

During the 12 March 2007 VA Compensation and Pension (C&P) examination, 4 months after separation, the CI reported left shoulder weakness, inability to lift heavy objections, stiffness, swelling, giving way, locking, lack of endurance, fatigability and dislocation. Physical examination showed no left shoulder edema, effusion, weakness, tenderness, abnormal movement or guarding of movement. Left shoulder flexion and abduction were 180 degrees, without pain, and ROM was not additionally limited by pain, fatigue, weakness, lack of endurance or incoordination with repetitive use. The neurologic and radiographic examinations did not reveal any abnormalities. The examiner stated there was no pathology to render a diagnosis.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left shoulder condition 10%, analogously coded “5299-5003" (degenerative arthritis). The VA did not rate the left shoulder condition, analogously coded 5299-5201 (arm, limitation of motion), but rather found it to be not service-connected based on the C&P examination, citing a noncompensable examination. The VASRD §4.71a threshold for rating ROM impairment (code 5201, arm limitation of motion) is “at shoulder level” (approximately 90 degrees from the side), but the STR and VA ROM evidence showed motion above this level. However, there was satisfactory evidence of painful motion (VASRD §4.59), as recorded on the MEB NARSUM examination to support a 10% rating. There was no fibrous union or nonunion of the humerus (5202), or clavicle or scapula impairment with loose movement (5203) to support a higher rating. 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 shoulder condition.

BOARD FINDINGS: In the matter of the left 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:

2	PD-2017-02971

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

I!J REPLY REFER T'J:
1850
CORB: 003
10 Sep 20

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

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR ofno change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.