RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-04985
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080303

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Human Resource Specialist, medically separated for “chronic right shoulder pain” with a disability rating of 10%.  

CI CONTENTION:  “Two surgeries on right shoulder (2004 & 2005).  Second surgery was due to clavicle damage during first surgery causing permanent deformity…”  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 - 20071105	VARD - 20080514	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Shoulder Pain	5099-5003	10%	Residuals, Resected Distal Clavicle, Right Side	5203	10%	20071212	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  70%	

ANALYSIS SUMMARY:  

Chronic Right Shoulder Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s injured his right shoulder in 2003 after a fall, and underwent a superior labral debridement and arthroscopic subacromial decompression in 2004.  He required a subsequent surgery in 2005 with a repeat debridement of the superior labrum as well as an arthroscopic distal clavicle excision.  The 25 July 2007 MEB NARSUM examination, 8 months prior to separation, noted CI complaints of right shoulder pain.  Physical examination showed pain with supraspinatus and infraspinatus testing, a positive O’Brien’s test (glenohumeral joint labral tear), and negative apprehension and relocation tests.  On examination, right shoulder range of motion (ROM), following repetition, showed flexion of 140 degrees (normal 180) and abduction of 115 degrees (normal 180).  Limitation of ROM was due to pain, and examiner noted decreased ROM during external rotation.  

At the 12 December 2007 VA Compensation and Pension (C&P) examination, 3 months before separation, the CI reported having chronic pain with stiffness in the morning, and exacerbations with shoulder use and exercise.  Following repetitive movement, flexion was to 160 degrees and abduction to 120 degrees.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right shoulder condition 10%, analogously coded 5099-5003 (arthritis, degenerative), citing slight and constant pain IAW the US Army Physical Disability Agency pain policy.  The VA also rated the right shoulder condition 10%, but coded 5203 (clavicle or scapula, impairment of), based on the C&P examination, citing malunion or nonunion of the clavicle or scapula.  Although there was insufficient limitation of motion to support a rating under code 5201, members agreed that a 10% rating was justified with application of VASRD §4.59 (painful motion).  There was no malunion or recurrent dislocation of the humerus to justify a rating under code 5202 (humerus, other impairment of); and no nonunion with loose movement of the clavicle to warrant the next higher 20% rating 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 right shoulder condition.  

BOARD FINDINGS:  In the matter of the chronic right 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.  

XXXXXXXXXX

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

Dear XXXXXXXXXX:

	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