RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX	CASE:  PD-2017-04108
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050621

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was a National Guard E4, Infantryman, medically separated for “left shoulder pain” 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 - 20050520	VARD - 20060128	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Shoulder Pain…	5099-5003	20%	Status Post Left Shoulder…Repair	5201	20%	20050910	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  50% 	

ANALYSIS SUMMARY:  

Chronic Left Shoulder Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent a coraco-clavicular ligament reconstruction on his left (non-dominant) shoulder in April 2004.  The 13 May 2005 MEB NARSUM examination, 1 month prior to separation, noted complaints of continued left shoulder pain that prevented performance of military duties such as carrying a weapon.  Physical examination showed left shoulder tenderness and crepitus, with range of motion (ROM) recorded as flexion to 90 degrees and abduction to 85 degrees (normal 180 for each), with painful motion noted. 
At the 10 September 2005 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported constant left shoulder pain, rated at 10/10 in severity, with occasional locking.  Measured ROM showed both flexion and abduction to 90 degrees, with painful motion.

During the 26 January 2006 physical medicine and rehabilitation examination, 7 months after separation, the CI continued to complain of left shoulder pain.  Physical examination showed flexion to 90 degrees and abduction to 90 degrees; painful motion was not addressed.  The therapist noted the CI tolerated treatment well without adverse reactions.   

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left shoulder condition 20%, coded 5099-5003 (analogous to degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA also rated the left shoulder condition 20%, but coded 5201 (limitation of arm motion), based on the C&P examination.  The 20% rating for the dominant or non-dominant arm requires motion limited to “at shoulder level” as noted by the MEB, VA and PM&R examinations.  There was no malunion with marked deformity or frequent episodes of recurrent dislocation of the humerus to justify a higher rating under code 5202 (humerus, other impairment of), and no higher rating available under code 5203 (clavicle or scapula, impairment of).  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 chronic left shoulder pain 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:

PD-2017-04108

AR20190011707, XXXXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXXXX

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.