RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXX	CASE: PD-2017-03641
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20050715

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Hull Technician, medically separated for “stable right shoulder status post (s/p) right open posterior capsular shift” with a disability rating of 10%.

CI CONTENTION: “In the 12 years I’ve been separated I’m still in pain and it doesn’t allow me to do all the things I would like to do.” 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 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 - 20050609	VARD - 20050917	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Stable Right Shoulder S/P Right
Open Posterior Capsular Shift	5099-
5003	10%	Right Shoulder Labral Tear, S/P Surgical Repair with Residual Scar	
7802-5203	
10%	
20050805	
Rotator Cuff Tendinitis	Cat II					
Right Shoulder Pain	Cat II					
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Stable Right Shoulder S/P Right Open Posterior Capsular Shift. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right non-dominant shoulder surgery in July 2004 for instability. Despite restrictions and physical therapy, his shoulder pain did not completely resolve. The 28 April 2005 MEB NARSUM examination, 3 months prior to separation, noted complaints of both anterior and posterior shoulder pain which radiated down the arm. Physical examination showed active range of motion (ROM) measured in degrees was flexion of 150 (normal 180), abduction of 170 (normal 180), external rotation of 90 degrees (normal) and internal rotation of 55 degrees (normal 90). There was slight pain with testing for acromioclavicular joint pathology (cross-arm adduction) and a positive test for impingement, equivalent to pain with motion (Hawkins sign).

At the 5 August 2005 VA Compensation and Pension (C&P) examination, one month after separation, the CI reported pain and weakness with flares-up. On physical examination there was no swelling, redness, or deformity of the right shoulder. There was tenderness and crepitus on abduction. Shoulder ROM measurements in degrees were flexion and abduction 160, respectively, , internal rotation of 70,and external rotation of 90. There was no pain on motion and no additional limitation of ROM or function by pain, fatigue, weakness, or lack of endurance following repetitive use.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right shoulder condition 10%, analogously coded 5099-5003 (degenerative arthritis). The PEB also listed rotator cuff tendinitis; and right shoulder pain as related Category II conditions that contributed to the primary unfitting condition but were not separately ratable. The impairment from the rotator cuff tendinitis and right shoulder pain were properly subsumed under the rating for the unfitting stable right shoulder s/p right open posterior capsular shift condition IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). The VA also rated the right shoulder condition 10%, dual coded 7802- 5203 (burn scars or scars due to other causes, not of the head, face, or neck, that are superficial and nonlinear - clavicle or scapula, impairment), based on the C&P examination, citing limited motion and tenderness.

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 examinations in evidence demonstrated motion above this level. Although there was insufficient 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) demonstrated on the NARSUM examination. 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 right shoulder condition.

BOARD FINDINGS: In the matter of the stable right shoulder status post right open posterior capsular shift 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.

2	PD-2017-03641

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
10 Sep 20

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

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.