RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:XXXXXXXXXXXXXXXXXXXXXXXXXXXXX		CASE: PD-2017-05280 BRANCH OF SERVICE: MARINE CORPS	SEPARATION DATE: 20091030

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Rifleman, medically separated for “adhesive capsulitis right shoulder” with a disability rating of 10%.

CI CONTENTION: Review requested review of 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 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 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 – 20090819	VARD – 20100413	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Adhesive Capsulitis Right Shoulder	5099-5003	10%	Right Shoulder Labral Tear	5201	10%	20100205	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 40%	

ANALYSIS SUMMARY:

Right Shoulder Adhesive Capsulitis. According to the service treatment record and MEB narrative summary (NARSUM), the CI underwent right (dominant) shoulder surgery (SLAP repair) in July 2008, and a  second procedure  (manipulation under anesthesia) on 15 October 2008.   At the   5 May 2009 orthopedic evaluation, range of motion (ROM) continued to improve with forward elevation to 170 degrees (normal 180) and some pain at extremes of motion.

During the 15 May 2009 MEB examination (recorded on DD Forms 2807-1 and 2808), 6 months prior to separation, elevation and abduction ROM was reported as 100 degrees and empty can testing was +4/5. The MEB NARSUM examination, 5 days later, noted complaints of chronic right shoulder pain and instability despite surgery and rehabilitation. No actual physical examination was completed. The 12 June 2009 MEB physical therapy ROM study, 5 months before separation, revealed right shoulder active flexion to 144 degrees and abduction to 143 degrees, after three repetitions, and with painful motion.

At the 5 February 2010 VA Compensation and Pension (C&P) examination, 3 months after separation, the CI reported instability, pain, stiffness and weakness, but denied episodes of dislocation, subluxation or locking. Physical examination showed crepitus, tenderness, weakness and guarding of movement. Right shoulder ROM, following repetitive movement, showed flexion of 142 degrees and abduction of 110 degrees, with objective evidence of painful motion. There was no additional limitation after three repetitions.

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). The VA also rated the right shoulder condition 10%, but coded 5201 (arm, limitation of motion), based on the C&P examination, citing objective evidence of painful motion. The VASRD §4.71a threshold for rating ROM impairment under code 5201 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). Panel members considered other VASRD shoulder and analogous codes, but all were less applicable and/or not advantageous for rating. There was therefore no higher rating 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.

The following documentary evidence was considered:

2	PD-2017-05280

DEPARTMENT OF THE NAVY
SECRETARY OF TIIE NAVY COUNCIL OF REVIEW BOARDS 720 KENNON STREET SE STE 309
WASHINGTON NAVY YARD, DC 20374-5023

I?-1 REPLY REFER TO :
1850
CORB: 003
10 Sep 20

From: Director, Secretary of the Navy Council of Review Boards To:	

Subj: PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) Ref:	(a) DoDI 6040.44
1.	Pursuant to reference (a), the PDBR reviewed your case and forwarded its recommendation to the Department of the Navy on 13 Aug 2020 for appropriate action.

2.	On 27 August 2020, the Assistant Secretary of the Navy (Manpower & Reserve Affairs) accepted the recommendation of the PDBR of no change to your characterization of separation or disability rating assigned by the Department of the Navy's Physical Evaluation Board.

3.	The Secretary's decision on your PDBR application is final and is not subject to appeal or additional review by the Board for Correction of Naval Records.