RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2019-00016
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20050527

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E3, Telephone Systems Journeyman, medically separated for “left shoulder pain” with a disability rating of 10%.

CI CONTENTION:  The left shoulder condition should have been rated higher under either code 5201 or 5202.  The CI claimed he was ambidextrous and also 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 - 20050413	VARD -  NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Shoulder Pain	5304	10%	No VA Examination Proximate to Separation in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Left Shoulder Pain.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the right-handed (per enlistment physical) CI underwent left shoulder rotator cuff surgery in December 2003.  Despite physical therapy, he had continued shoulder instability and underwent subscapularis muscle shortening in October 2004 to stabilize the left shoulder joint.  The 7 January 2005 orthopedic memorandum, 2 months after surgery, showed 90 degrees of abduction (normal 180) with popping and minimal pain.  During the 10 March 2005 MEB NARSUM examination, 3 months prior to separation, the CI complained of limited range of motion (ROM), weakness and a grinding sensation in his left shoulder joint.  Physical examination showed limitation of motion in all directions with crepitation, but did not quantify the limitation.  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%, coded 5304 (Muscle Group IV injury).   Panel members noted a paucity of STR ROM evidence.  The sole probative ROM finding for the left shoulder proximate to separation was found on a memorandum from the CI’s orthopedic provider, 2 months after surgery, and reflected 90 degrees of abduction.  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 CI’s left arm was limited to that level.  Therefore, a 20% rating is warranted for limitation of motion.  There was no fibrous union or nonunion of the humerus to justify a higher rating under the 5202 code (humerus, other impairment), and no higher rating available 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 recommends a disability rating of 20% for the left shoulder condition, coded 5201.  

BOARD FINDINGS:  In the matter of the left shoulder condition, the panel recommends a disability rating of 20%, coded 5201 IAW VASRD §4.71a.  There are no other conditions within the panel’s scope of review for consideration.  

The panel recommends the CI’s prior determination be modified as follows, effective the date of medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Left Shoulder Pain	5201	20%	

SAF/MRB
3351 Celmers Lane
JBA NAF Washington, MD 20762-6435

Dear XXXXXXXXXX,

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2019-00016.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was not in accordance with the guidelines of the Veterans Affairs Schedule for Rating Disabilities.  Accordingly, the Board recommended modification of your assigned disability rating without re-characterization of your separation with severance pay. 

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding, accept the recommendation and direct that your records be corrected as set forth in the attached copy of a Memorandum for the Chief of Staff, United States Air Force.  This will not result in any change to your separation documents or the amount of severance pay you are entitled to.  Disability severance pay is computed the same regardless of a rating of 0, 10 or 20 percent.