RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW
NAME: XXXXXXXXXXXXXXXXXXXXXX	CASE: PD-2017-05652
BRANCH OF SERVICE: NAVY	SEPARATION DATE: 20061226

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Communication Security Maintenance Technician, medically separated for “left shoulder acromioclavicular [AC] arthrosis status post [S/P] left acromioplasty and subacromial decompression” with a disability rating of 10%.

CI CONTENTION: Review requested of shoulder condition as well as an additional condition (sleep apnea) not identified by the Medical Evaluation Board (MEB) and/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 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 - 20060906	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Shoulder AC Arthrosis…	5299-5003	10%	
No VA Examination Proximate to Separation in Evidence	
Persistent Left Shoulder Pain Despite Conservative and Surgical Care	Cat II		
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: NA	

ANALYSIS SUMMARY:

Left Shoulder Acromioclavicular Arthrosis. According to the service treatment record and MEB narrative summary (NARSUM), the CI injured his left shoulder (non-dominant) in a motor vehicle accident in October 2004. An MRI performed in May 2005 showed AC arthrosis as well as local tendinosis. Despite aggressive physical therapy and local injections, the pain continued and he underwent surgical intervention in January 2006. During an orthopedic visit on 24 April 2006, 8 months prior to separation, the CI was “doing okay.” Physical examination revealed left shoulder tenderness with range of motion (ROM) measurements showing both forward flexion and abduction to 150 degrees each (normal 180).

The 10 July 2006 MEB NARSUM examination, 5 months prior to separation, noted CI complaints of severe left shoulder pain with overhead work, lifting greater than 20 pounds, pushups, pull- ups, working overhead, or lying on the shoulder The examiner noted tenderness and pain with

clinical impingement tests, but no joint laxity. Flexion was to 145 degrees and abduction to 115 degrees, with painful motion. There was no VA examination proximate to separation in evidence.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the left shoulder condition 10%, analogously coded 5299-5003 (degenerative arthritis), and listed “persistent left shoulder pain despite conservative and surgical care” as a related Category II condition (contributes to the primary unfitting condition but not separately ratable). Panel members agreed this related condition was properly subsumed under the overall rating for the left shoulder condition, IAW §4.14 (avoidance of pyramiding; more than one rating based on the same impairment is prohibited). 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 warranted with application of VASRD §4.59 (painful motion) as evidenced in the NARSUM examination. 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.

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.

The following documentary evidence was considered:

2	PD-2017-05652

DEPARTMENT OF THE NAVY
SECRETARY OF  nm NAVY  COUNCIL  OF  REVIEW  BOARDS 72 0 KBmON STREET SE STE 3 0 9
WASHINGTON NAVY YARD, DC 20374-5023

IN 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 ofno 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.