RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXX	CASE: PD-2017-03531
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20080523

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, F/A-18 Systems Organizational Career Maintenance Technician, medically separated for “right shoulder subluxation” with a disability rating of 20%.

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 - 20080220	VARD - 20090126	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Shoulder Subluxation	5202	20%	Status Post Arthroscopy with Anterior Labral Reattachment and Subacrumiale Decompression surgery, Right Shoulder	5201	30%	20080723	
Right Shoulder, Multi- directional Instability	Cat II					
COMBINED RATING: 20%	COMBINED RATING OF ALL VA CONDITIONS: 80%	
	
ANALYSIS SUMMARY:

Right Shoulder Subluxation. According to the service treatment record and MEB narrative summary (NARSUM), the right-handed CI underwent right shoulder Bankart repair with capsular plication in March 2007. The 5 November 2007 MEB NARSUM examination, 6 months prior to separation, noted complaints of right shoulder pain and decreased motion. On examination, the load and shift test showed some posterior subluxation without frank dislocation and a positive apprehension test. Right shoulder range of motion (ROM) testing, following repetitive movement, showed flexion and abduction of 120 and 90 degrees, respectively (normal 180) with

painful motion. During the MEB examination (recorded on DD Forms 2807-1 and 2808), 4 days later, physical examination showed an inability to abduct past 90 degrees, but he could forward flex to 170 degrees. The 29 December 2007 MEB NARSUM addendum, 5 months prior to separation, noted no dramatic improvement in function or pain, but the CI reported continued difficulties with overhead activities, pain and weakness. Physical examination showed shoulder tenderness. The ROM study showed flexion of 140 degrees and abduction of 85 degrees. At the 8 January 2008 physical therapy examination the CI reported 2/10 shoulder pain. The ROM study showed flexion of 135 degrees and abduction of 105 degrees with pain starting at 70 degrees. The therapist noted that strength continued to improve, but ROM had plateaued. The 4 February 2008 MEB NARSUM addendum showed flexion of 160 degrees and abduction of 75 degrees with pain in all planes of motion.

At the 23 July 2008 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported pain, tenderness, crepitus and stiffness in the morning. On examination, right shoulder ROM, following repetitive movement, showed flexion of 130 degrees and abduction of 60 degrees. The examiner noted impingement and pain with abduction. The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right shoulder condition 20%, coded 5202 (humerus, other impairment), citing infrequent episodes and guarding of motion at shoulder level. The Navy PEB also listed multi-directional instability as a related Category II condition (contributed to the primary unfitting condition but was not separately ratable). The impairment from the multi-directional instability was properly subsumed under the overall rating for the right shoulder condition to avoid pyramiding (§4.14). The VA rated the right shoulder condition 30%, coded 5201 (arm, limitation of motion), based on the C&P examination, citing limitation of arm motion midway between side and shoulder level. There panel noted there was no malunion with marked deformity of the humerus or frequent episodes of recurrent dislocation with guarding of all arm movements to warrant the next higher 30% rating under code 5202. There was likewise no higher rating for limitation of motion (5201), and no higher ratings available 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 majority 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 majority recommends no change in the PEB adjudication. The single voter for dissent recommends a disability rating of 30%, but did not elect to submit a minority opinion. 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.

2	PD-2017-03531

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 20May20

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 <ltd 14 May 19

1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation (reference (b)) to the Department of the Navy on 5 Mar 2020 for appropriate action.

2.	On 20 March 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no 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.