RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX		CASE: PD-2017-05149 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20050617

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Ground Surveillance Radar Operator, medically separated for “left shoulder pain” with a disability rating of 10%.

CI CONTENTION: No specific contention was made. 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 - 20050602	VARD - 20060711	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain, Left Shoulder	5099-5003	10%	Left Shoulder	5299-5201	0%	20060607	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Left Shoulder Pain. According to the service treatment record and MEB narrative summary (NARSUM), the CI’s left shoulder condition began in October 2002 after doing push-ups. MRI of the left shoulder on 15 April 2004, 14 months prior to separation, revealed a normal study. The tendinous and ligamentous structures of the shoulder had normal signal characteristics and morphology. The glenoid labrum was normal in appearance and the bone marrow was normal as well. There was a type I acromion without evidence of bone spur formation. At the time of the orthopedic clinic appointment on 20 January 2005, 5 months prior to separation, the CI reported left shoulder pain. On examination there was tenderness of the left shoulder trapezius muscle but no swelling, redness or fluid were present. His shoulder showed no weakness and range of motion (ROM) was normal but there was pain with motion.

During the 9 March 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 3 months prior to separation, the CI reported constant 7/10 left shoulder pain with most movement. Physical examination revealed left shoulder supraspinatus muscle tenderness and 4/5strength. The same-day MEB NARSUM examination noted complaints of moderate and constant left shoulder pain at rest that increased to marked pain while doing activities such as push-ups or

overhead reaching. Physical examination revealed no overlying rash or deformity, point tenderness or joint tenderness. Left shoulder ROM performed by PT on 14 March 2005 showed flexion of 160 degrees (normal 180) and abduction of 170 degrees (normal 180). Painful motion was noted in all planes.

At the 7 June 2006 VA Compensation and Pension (C&P) examination, 12 months after separation, the CI reported constant left shoulder pain (7/10). Pain was aggravated by any overhead motion and heavy lifting. He occasionally had flare-ups with repetitive motion, which made the pain go up to 8/10. The CI worked as a phone installer and had missed 2 to 3 days of work since employment in the past 2 months. Physical examination showed no acromioclavicular joint tenderness and no tenderness on rotary motion. Left shoulder ROM showed flexion and abduction of 180 degrees, both without painful motion. He had good resistive strength of the left shoulder and there was no change in ROM, coordination, fatigability, endurance, or pain level with repetitive motion.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left shoulder condition 10%, analogously coded 5003 (degenerative arthritis), citing the US Army Physical Disability Agency pain policy. The VA rated the left shoulder condition 0%, analogously coded 5201 (arm, limitation of motion), based on the C&P examination, citing normal ROM with all ROM performed without pain. 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. Although there was insufficient limitation of motion to support a rating under the 5201 code, panel 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 the 5202 code (humerus, other impairment); and no nonunion with loose movement of the clavicle to warrant the next higher 20% rating under the 5203 code (clavicle or scapula, impairment). 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.

BOARD FINDINGS: In the matter of the left 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.

2	PD-2017-05149

ARXXXXXXXXXXX, XXXXXXXXXXXXXXXXXXXX. 

Dear XXXXXXXXXXXXXXXXXXX:

	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.