RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05039
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080831

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty, E4, Combat Engineer, medically separated for “football injury to right shoulder” with a  disability rating of 10%.  

CI CONTENTION:  Requested review of his shoulder condition.  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 - 20080703	VARD - 20090303	
Condition	Code	Rating	Condition	Code	Rating	Exam	
…Injury to Right Shoulder 	5099-5003	10%	Right Shoulder Rotator Cuff Tendonitis	5201-5024	10%	20081105	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Shoulder Injury.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s right shoulder condition began after a fall while playing football in October 2006.  Diagnosed with a labrum and partial thickness rotator cuff tear, non-surgical treatment was provided, but he continued to have persistent pain.  The 18 June 2008 MEB NARSUM examination, 2 months prior to separation, noted complaints of persistent right shoulder pain.  Physical examination noted full, bilateral active range of motion (ROM) with pain on the right “described at the upper limit of abduction.”  On 30 June 2008, measured ROM in physical therapy noted painful and decreased right shoulder motion with flexion to 130 degrees (normal 180) and abduction to 140 degrees (normal 180).  

At the 5 November 2008 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported right shoulder weakness, stiffness, and moderate to severe painful flare-ups, 3-4 times per week. Physical examination revealed decreased right shoulder ROM with flexion to 150 degrees and abduction of 120 degrees.  Internal rotation was listed as well as another measurement labeled as “abduction” at 45 degrees.  Guarding of the right shoulder was present, but there was no painful motion.

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 painful motion.  The VA rated the right shoulder condition 10%, dual coded as 5201-5024 (arm, limitation of motion-tenosynovitis), based on the C&P examination, citing painful or limited motion of a major joint.  Members first considered the apparent duplicative listing of right shoulder abduction of both 120 degrees and 45 degrees, and concluded that based upon prior descriptions of shoulder ROM, the 45 degree motion was actually “adduction” and therefore, indicative of an error in the transcription of the record.  The panel agreed that the persistence of painful motion on the PEB examination was easily supported under VASRD §4.59 to achieve the minimal compensable 10% rating.  However, there was no compensable ROM under code 5201, clinical evidence of ankylosis or nonunion/malunion of any component of the shoulder girdle, or history of recurrent shoulder dislocation for a VASRD §4.71a rating higher than the 10% adjudicated by the PEB.  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.  

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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