RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-04848 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20070930

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Rifleman, medically separated for “right shoulder pain” 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 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 - 20070801	VARD - 20071106	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Shoulder Pain…	5099-5003	10%	Rotator Cuff Tear, Right Shoulder	5201-5021	10%	20071002	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Right Shoulder Pain. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s right shoulder condition began without a specific known injury in 2005; there has been frequent pain since that time. MRI of the right shoulder on 11 May 2007, 5 months prior to separation, revealed no definite labral tear. There was a questionable minimal partial undersurface tear of the anterior aspect of the supraspinatus tendon and a possible posterior humeral avulsion of the glenohumeral ligament lesion. At the primary care clinic 4 days later, the CI reported right shoulder pain. On examination there was tenderness of the acromioclavicular joint. Neer impingement and crossed arm impingement testing results were both positive. Hawkins-Kennedy impingement and O’Brien’s testing were both negative. Both shoulder joints had full range of motion (ROM) and pain was elicited by motion with a painful glenohumeral arc. There was weakness of the infraspinatus muscle (4/5) and the examiner opined that effort seemed to be related with pain.

The 27 June 2007 MEB NARSUM examination, 3 months prior to separation, noted complaints of intermittent right shoulder pain. The CI reported it was difficult to wear a heavy pack and lift heavy things.. Physical examination showed motor strength was 5/5 and he was distally

neurovascular intact. Right shoulder ROM was decreased with forward flexion of 150 degrees (normal 180) versus 180 degrees on the contralateral side. The CI was able to voluntarily produce a clonk in his shoulder, which was painful.

At the 2 October 2007 VA Compensation and Pension (C&P) examination, 2 days after separation, the CI reported right shoulder pain, usually about once a day, lasting 10-20 minutes at a time. He stated he had pain with heavy lifting or overhead reach. Physical examination showed right shoulder ROM flexion of 150 degrees and abduction of 120 degrees (normal 180). Painful motion was noted at ROM extremes.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the right shoulder condition 10%, analogously coded 5003 ( degenerative arthritis). The VA also rated the right shoulder condition 10%, dual coded 5201-5021 (arm, limitation of motion of-myositis), based on the C&P examination, citing limited and painful right shoulder motion. 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). The panel considered other VASRD shoulder and analogous codes, but these were less applicable and/or not advantageous for rating. 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.

The following documentary evidence was considered:

2	PD-2017-04848

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:	

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.