RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04832
BRANCH OF SERVICE:  army 	SEPARATION DATE:  20080723

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Human Resources Specialist, medically separated for “loss of motion of right (dominant) arm” with a disability rating of 20%.

CI CONTENTION:  “Review all Conditions.”  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 - 20080509	VARD - 20090324	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Loss of Motion of Right Arm	5010-5201	20%	Right Shoulder Tendonitis	5201-5024	10%	20081030	
Right Ankle Sprain	Not Unfitting	Right Ankle Strain	5024	0%	20081030	
Allergic Rhinitis	Not Unfitting	Allergic Rhinitis	6514-6522	0%	20081030	
History of Positive PPD	Not Unfitting	No VA Placement	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY: 

Loss of Motion of Right (Dominant) Arm:  According to the service treatment record and MEB narrative summary (NARSUM), the CI originally fractured her right shoulder in 2001 which initially healed without surgery, but secondary to increased scar tissue, she underwent surgical manipulation in February 2004.   Her right shoulder remained intermittently painful for the next 4 years despite frequent physical therapy (PT) treatment.    

At the 17 January 2008 PT examination, 6 months prior to separation, the CI reported constant right upper extremity pain that increased with activity or elevation of the arm.  Right shoulder range of motion (ROM) revealed flexion to 160 degrees (normal 180) and abduction to 151 degrees (normal 180) with painful motion.  At the 13 February 2008 orthopedic examination, 5 months prior to separation, the CI endorsed right shoulder pain.  Her physical examination (PE) revealed diffuse tenderness about the right shoulder joint.  ROM noted flexion to 160 degrees and abduction to 150 degrees.  No instability was noted.  

During the 12 March 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI reported tingling from her right shoulder down to her fingers.  She also reported that she could not lift her arm to full ROM.  Her PE noted painful shoulder flexion to 120 degrees and painful abduction to 75 degrees.  According to the 9 April 2008 MEB NARSUM evaluation, 3 months prior to separation, the CI experienced increased right shoulder pain and decreased ROM.  Shoulder dislocations were not reported.  After repetitive motion the right shoulder flexion was 120 degrees and abduction was 75 degrees.  Local tenderness and painful motion was present.  

At the 30 October 2008 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported pain and limited ROM.  Shoulder flexion and abduction was painful and measured at 170 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right (dominant) arm condition 20%, coded 5010-5201 (traumatic arthritis causing limitation of arm motion), citing abduction of 75 degrees.  The VA rated the right arm condition 10%, coded 5201-5024 (limitation of arm motion due to tendonitis), citing painful or limited motion of a major joint.  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 pre-separation examinations most proximate to separation, in evidence, demonstrated motion limited to this level.  The next higher 30% rating for the dominant arm requires motion limited to “midway between side and shoulder level.”  However, examinations did not reflect this degree of limitation.  There was no malunion with marked deformity or frequent episodes of recurrent dislocation of the humerus to justify a higher rating under the 5202 code (humerus, other impairment of), and no higher ratings available under the 5203 code (clavicle or scapula, impairment of).  After due deliberation, considering all of 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.

Contended PEB Conditions:  Right Ankle Sprain, History of Positive PPD and Seasonal Rhinitis.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  None of the conditions were profiled, implicated in the commander’s statement nor judged to fail retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions and so no additional disability ratings are recommended.

BOARD FINDINGS:  In the matter of the right shoulder condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication.  In the matter of the contended right ankle condition, positive PPD and allergic rhinitis, the panel recommends no change from the PEB determinations as not unfitting.  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:

Exhibit A.  DD Form 294, dated 20170517, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20180006732 XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	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.

Sincerely,					      
Enclosure