ECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-04977
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060421

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Military Policeman, medically separated for “chronic left shoulder pain” with a disability rating of 0%.  

CI CONTENTION:  “Conditions have worsened to the point of complete numbness in my shoulder and severe back pain.”  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 - 20060306	VARD - 20060919	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Shoulder Pain	5024	0%	Biceps Tendonitis with Chronic Left Shoulder Pain	5024-5201	20%	20060823	
Intermittent Lower Back Pain	Not Unfitting 	Lumbosacral Strain	5237	10%	20060823	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Chronic Left Shoulder Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left shoulder condition began in October 2004 after a fall.  During the 13 December 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI reported severe left shoulder pain.  On examination the left shoulder range of motion (ROM) following repetitive movement showed flexion of 120 degrees (normal 180) and abduction of 140 degrees (normal 180) with painful motion and joint tenderness.  At the 13 February 2006 MEB NARSUM examination, 2 months prior to separation, the CI complained of “tight and sore shoulder pain 70 to 75% of the time,” aggravated by lifting more than 15 pounds, overhead activities, push-ups, running or wearing load-bearing equipment.  Physical examination showed ROM following repetitive movement of flexion of 140 degrees and abduction of 150 degrees.  

The 23 August 2006 VA Compensation and Pension (C&P) examination, 4 months after separation, physical examination showed ROM following repetitive movement flexion of 90 degrees and abduction of 90 degrees with painful motion.  The examiner noted some tenderness over the distal clavicle.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left shoulder condition 0%, coded 5024 (tenosynovitis), citing tenosynovitis without loss of joint motion.  The VA rated the left shoulder condition 20%, dual coded 5024-5201 (tenosynovitis - limitation of arm motion), based on the C&P examination, citing limitation of arm motion at shoulder level.  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 prior to separation demonstrated motion above this level.  However, panel members agreed that a 10% rating was justified with application of VASRD §4.59 (painful motion) and §4.40 (functional loss).  There was no malunion or recurrent dislocation of the humerus to justify a higher rating under code 5202 and no dislocation or nonunion of the clavicle or scapula to justify a higher rating under code 5203.  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 left shoulder condition, coded 5024  

Contended PEB Condition:  Lower Back Pain.  The panel’s main charge is to assess the fairness of the PEB determination that the contended condition was not unfitting.  The contended condition was not profiled, or judged to fail retention standards.  There was no performance-based evidence from the record that the condition 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 the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the left shoulder condition, the panel recommends a disability rating of 10%, coded 5024 IAW VASRD §4.71a.  In the matter of the contended back condition, the panel agrees it cannot recommend it for additional disability rating.  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	
Chronic Left Shoulder Pain	5024	10%	

XXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

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.

Sincerely,					      
Enclosure