RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-04244
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050908

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an E6 National Guard, Military Policeman, medically separated for “right shoulder pain” and “chronic neck pain,” rated 0% each, with a combined disability rating of 0%.  

CI CONTENTION:  “Right shoulder, cervical spine.”  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 - 20050803	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Shoulder Pain	8714	0%	No VA Examination Proximate to Separation in Evidence	
Chronic Neck Pain	5237	0%		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Right Shoulder Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the right hand dominant CI underwent right shoulder surgery in October 2003 for a rotator cuff injury.  Following surgery, he improved, but still noted pain and limited motion which impaired full duty.  Radiographic studies did “not show any gross anomaly.”  The 9 March 2005 MEB NARSUM examination, 6 months prior to separation, showed right shoulder range of motion (ROM) measurements of 140 degrees of flexion (normal 180) and 180 degrees of abduction (normal).  Pain was present at the limit of abduction and flexion and abduction of the unaffected left shoulder were identical to the right shoulder.  The neurological examination was intact.  In physical therapy on 15 April 2005, flexion was noted to be 168, 167, and 158 degrees, nearly the same as the left shoulder.  Abduction was 165, 165, and 166 degrees.  Painful motion was not recorded.  There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right shoulder condition 0%, coded 8714 (neuralgia), citing pain with motion.  The limitation in motion of the right shoulder did not support a compensable rating under the 5201 code, but a 10% rating is supported under the 5003 code (degenerative arthritis) for limited and painful motion.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right shoulder condition, analogously coded 5099-5003.  

Chronic Neck Pain.  According to the STR and MEB NARSUM, an MRI of the cervical spine done on 10 October 2004 showed a small right sided disc protrusion at C6-7 with possible impingement of the right C7 nerve root.  [Presumably, this was done as part of the evaluation of the right shoulder condition, but this was not clear from the records in evidence.]  The CI noted shooting pain from his neck into both arms with weakness.  The MEB NARSUM examination showed full flexion and a combined ROM of 315 degrees (normal 340).  Extension resulted in a sensation of lightheadedness, but pain was not recorded.  As noted above, the neurological examination was normal.  During the 31 March 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the ROM was full and neurological examination normal.  The ROM measurements in physical therapy on 15 April 2005, showed flexion exceeding the normal 45 degrees and combined ROM of 235 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the neck condition 0%, coded 5237 (cervical strain), citing arthritis.  The panel noted that the limitation of combined ROM on the NARSUM and physical therapy examinations supported a 10% rating.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the neck condition, coded 5237.  

BOARD FINDINGS:  In the matter of the right shoulder condition, the panel recommends a disability rating of 10%, coded 5099-5003 IAW VASRD §4.71a.  In the matter of the neck condition, the panel recommends a disability rating of 10%, coded 5237 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Right Shoulder Pain	5099-5003	10%	
Chronic Neck Pain	5237	10%	
COMBINED	20%	

The following documentary evidence was considered:  

AR20190004346, XXXXXXXXXX

Dear XXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.