RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-03953 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20051115

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Security Force Guard, medically separated for “right shoulder joint pain and stiffness following surgical stabilization” with a disability rating of 10%.

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 – 20050901	VARD - 20060110	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Shoulder Joint Pain…	5299-5003	10%	Residuals, Post-Operative Right Shoulder	5299-5203	10%	20050715	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 70%	

ANALYSIS SUMMARY:

Right Shoulder Joint Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent arthroscopic surgery on 21 May 2004 for repair of a torn right shoulder labrum. At the 23 September 2004 orthopedic appointment, he was doing well with minimal pain, and right shoulder range of motion (ROM) was normal in both forward flexion and abduction (180 degrees). At the 13 January 2005 follow-up, the CI complained of pain with stiffness, and forward flexion was measured to 180 degrees. On 12 August 2005, the orthopedist found no swelling, tenderness or deformity. Right shoulder ROM measurements showed flexion of 160 degrees and abduction of 120 degrees, with painful motion.

At the 15 July 2005 VA Compensation and Pension (C&P) examination, 4 months before separation, the CI reported chronic right shoulder pain aggravated by increased activity and difficulties with reaching across the body or behind the back. The physical examination (PE) revealed right shoulder forward flexion to 160 degrees and abduction to 90 degrees. The examiner stated that the right shoulder joint ROM was limited by severe pain, fatigue, weakness, lack of endurance and incoordination with even the slightest repetitive motion.

An orthopedic follow-up appointment on 12 August 2005, 3 months prior to separation, noted no right shoulder swelling, tenderness or deformity. Forward flexion was to 160 degrees and abduction to 120 degrees, with painful motion. Three days later, the MEB NARSUM examination noted complaints of constant right shoulder pain aggravated by any type of reaching. The PE revealed no significant deformity or atrophy, and the examiner referred to the orthopedic ROM measurements as noted above.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right shoulder condition 10%, analogously coded 5299-5003 (arthritis, degenerative). The VA also rated the right shoulder condition 10%, but analogously coded 5299- 5203 (clavicle or scapula, impairment of) based on the C&P examination, citing limited flexion and abduction due to pain. Panel members noted that the VASRD §4.71a threshold for rating ROM impairment under code 5201 (arm limitation of motion) is “at shoulder level” (approximately 90 degrees from the side), and the examinations in evidence closest to separation demonstrated motion limitations above this level. However, the panel agreed that a 10% rating was justified with application of VASRD §4.59 (painful motion). There was no malunion or recurrent dislocation of the humerus to justify a rating under code 5202 (humerus, other impairment of); and no nonunion with loose movement of the clavicle to warrant the next higher 20% rating under code 5203. 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 right 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.

2	PD-2017-03953

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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 dtd 12 Sep 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.