RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-05063
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050318

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

CI CONTENTION:  In addition to the right shoulder condition, the CI requested review of additional conditions not identified by the Medical Evaluation Board (MEB) or Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the 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 - 20050222	VARD - 20050524	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain, Right Shoulder	5099-5003	10%	Status Post Repair, Right Rotator Cuff	5201-8516	10%	20050509	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Pain, Right Shoulder.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s underwent surgery to repair a torn rotator cuff in April 2004.  He re-injured the right shoulder while exercising in October 2004 and was referred to orthopedics, but surgery was not indicated.  At the 12 January 2005 MEB NARSUM examination, 9 months after surgery and 2 months prior to separation, the CI complained of daily right shoulder pain.  Physical examination revealed tenderness without neurological deficits.  Range of motion (ROM), as measured by physical therapy, was reported as flexion to 180 degrees (normal) and abduction to 173 degrees (normal 180), with painful motion.  

At the 9 May 2005 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported persistent right shoulder pain brought on by use of the arm, but indicated it did not affect activities of daily living and that he did not feel it would negatively impact his civilian job.  Physical examination showed well-healed surgical scars and no atrophy.  ROM was recorded as flexion to 180 degrees and abduction to 160 degrees, with pain at extreme abduction.  Testing for possible shoulder impingement was positive (Neer’s sign) and cross-chest adduction caused slight pain.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right shoulder at 10%, coded 5099-5003 (analogous to degenerative arthritis) citing the US Army Physical Disability Agency pain policy.  The VA also rated the shoulder at 10%, dual coded 5201-8516 (limitation of arm motion – paralysis of the ulnar nerve), based on the C&P examination.  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.  However, panel members agreed that a 10% rating was justified with application of VASRD §4.59 (painful motion) based on the MEB and primary care clinic examinations proximate to separation.  There was no malunion or recurrent dislocation of the humerus and no dislocation or nonunion of the clavicle or scapula to justify a higher rating under the 5202 (humerus, other impairment of) or 5203 (clavicle or scapula, impairment of) codes.  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, 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.  

AR20180015233, 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.