RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXX 	CASE:  PD-2017-05175
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060517

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Food Service Operations Specialist, medically separated for “chronic 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’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 - 20060324	VARD - 20061030	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Shoulder Pain	5099-5003	10%	Gleno-Humeral Arthritis, Left Shoulder	5010	10%	20060705	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Left Shoulder Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent surgery in April 2005 to remove a bony loose body (osteophyte) from the left shoulder (non-dominant).  Electrodiagnostic studies were normal.  During the 1 December 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, the CI reported continuing chronic left shoulder pain.  Physical examination showed mild grinding with all ranges of motion (ROM), with no pain on flexion or abduction.  Strength was recorded as 5/5.  There was no atrophy of the left deltoid and sensation was intact in the left arm.  Grip strength was equal left and right.  At the physical therapy ROM study the next day, flexion and abduction were both 180 degrees (normal).

At the 8 January 2006 MEB orthopedic consultation, 4 months prior to separation, the CI complained of persistent left shoulder pain rated 5-8/10 in severity.  Physical examination revealed full ROM with some decreased definition of the deltoid and triceps musculature compared to the right.  There was slight, mildly audible crepitus of the left shoulder (a crackling or grinding noise or sensation).  

During the 5 July 2006 VA Compensation and Pension (C&P) examination, 2 months after separation, the CI reported constant left shoulder pain rated 4-5/10 in severity that prevented lifting or moving furniture.  He denied the use of assistive devices and had flare-ups with heavy lifting.  The ROM examination showed flexion of 180 and abduction of 175 degrees with pain.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left shoulder at 10%, coded 5099-5003 (analogous to degenerative arthritis), citing slight and constant pain IAW the US Army Physical Disability Agency pain policy.  The VA also rated the shoulder at 10%, but coded 5010 (arthritis due to trauma), 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.  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 mal union or recurrent dislocation of the humerus to justify a rating under the 5202 code (humerus, other impairment of); and no nonunion with loose movement of the clavicle to warrant the next higher 20% rating under the 5203 code (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 left shoulder pain.  

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.

 XXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXXXX

	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.