RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME:  XXXXXXXXXXXXXXXXXX	CASE: PD-2017-05140
BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20051030

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

CI CONTENTION: Review requested of the left shoulder and neck conditions, which required surgery, as well as additional conditions not identified by the Medical Evaluation Board (MEB) and 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 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 - 20050831	VARD - 20060330	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Shoulder Pain	5003	10%	Left Shoulder Acromioclavicular Joint Degenerative Joint Disease [DJD]	5010	10%	
20051108	
Mild Intermittent Left Neck Pain
Secondary to Left Shoulder Pain	Not Unfitting	Cervical Spondylosis	5242	20%		
COMBINED RATING: 10%	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 gradually experienced left (non-dominant) shoulder pain in October 2003 with no specific injury. In November 2004, he underwent left shoulder arthroscopic subacromial decompression and a distal clavicle resection for subacromial impingement and acromioclavicular joint arthritis. In December 2004, X-rays showed the clavicle was stable with no abnormal movement. After continued residual pain, the CI had a second arthroscopic subacromial decompression for left shoulder impingement syndrome in March 2005. Despite postoperative physical therapy, the pain persisted.

During the 10 August 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported chronic left shoulder pain, and the examiner recorded flexion

to 157 degrees (normal 180) and abduction to 144 degrees (normal 180). The 23 August 2005 MEB NARSUM noted complaints of left shoulder pain, and the examiner repeated the MEB examination ROM measurements. At the 8 November 2005 VA Compensation and Pension (C&P) examination, 1 month after separation, the CI reported daily left shoulder pain. Physical examination showed normal biceps and triceps, with an intact supinator jerk (to determine a brachioradialis muscle reflex arc) as well as median, ulnar, and radial nerve functions. The diagnosis was acromioclavicular DJD with chronic postoperative residual pain.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left shoulder condition 10%, coded 5003 (arthritis, degenerative), citing a major joint with radiographic evidence of degenerative changes and slight loss of motion. The VA also rated the left shoulder condition 10%, but coded 5010 (arthritis, due to trauma) based on the C&P examinations, citing painful or limited motion of a major joint. Panel members noted that the VASRD §4.71a threshold for rating for ROM impairment under 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, a 10% rating was justified with application of VASRD §4.59 (painful motion). The panel considered other VASRD shoulder and analogous codes, but all 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 left shoulder condition.

Contended PEB Condition: Mild Intermittent Left Neck Pain Secondary to Left Shoulder 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 implicated in the commander’s statement, and did not 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 and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication. In the matter of the contended neck condition, the panel recommends no change from the PEB determination as not unfitting. 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.

2	PD-2018-00492

ARXXXXXXXXXXX,XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXX:

	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.