RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1100812 SEPARATION DATE: 20071115 

BOARD DATE: 20121113 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (13F/Fire Support Specialist), medically 
separated for a chronic pain, right (dominant) shoulder condition. The CI initially injured the 
right shoulder in 2003 and was managed conservatively. He reinjured the shoulder and 
underwent an arthroscopic repair in 2005 with good results. He was able to deploy, but had 
recurrent pain which lead to a second operation in 2007. Despite rehabilitation, he could not 
meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical 
fitness standards. He was consequently issued a permanent U3 profile and referred for a 
Medical Evaluation Board (MEB). The MEB forwarded “right shoulder pain, nonspecific” to the 
Physical Evaluation Board (PEB) as medically unacceptable IAW AR 40-501. No other conditions 
were submitted by the MEB. The PEB adjudicated the chronic pain, right (dominant) shoulder 
condition as unfitting, rated 0% analogously to 5003 (arthritis), with application of the US Army 
Physical Disability Agency (USAPDA) pain policy. The CI made no appeals and was medically 
separated with a 0% disability rating. 

 

 

CI CONTENTION: “I received a medical board for chronic pain right (dominant) shoulder. The 
medical board should have reviewed the right superior labrum anterior and posterior tear with 
subacromial bursitis and impingement status post surgical intervention with residual scars.” 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in DoDI 
6040.44, Enclosure 3, paragraph 5.e.(2) is limited to those conditions which were determined 
by the PEB to be specifically unfitting for continued military service; or, when requested by the 
CI, those condition(s) “identified but not determined to be unfitting by the PEB.” The ratings 
for unfitting conditions will be reviewed in all cases. The right shoulder condition requested for 
consideration meets the criteria prescribed in DoDI 6040.44 for Board purview; and is 
addressed below. Any conditions or contention not requested in this application, or otherwise 
outside the Board’s defined scope of review, remain eligible for future consideration by the 
Army Board for Correction of Military Records. 

 

 

RATING COMPARISON: 

 

Service IPEB – Dated 20070718 

VA (3 Mos. Pre -Separation) – All Effective Date 20071116 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic Pain, R Shoulder 

5099-5003 

0% 

Right Superior Labrum 
Tear…with Residual Scars 

5299-5201 

30%* 

20070823 

.No Additional MEB/PEB Entries. 

Adj Disorder with Anxiety 

9499-9440 

30% 

20070823 

Deg Arthritis of the LS Spine 

5003-5242 

20% 

20070823 

RPPS 

5299-5260 

10% 

20070823 

Right Ankle Strain 

5299-5271 

10% 

20070823 

Tinnitus 

6260 

10% 

20070823 

0% X 3 / Not Service-Connected x 2 

20070823 

Combined: 0% 

Combined: 70% 



*Decreased to 20% effective 20101001. 


ANALYSIS SUMMARY: 

 

Chronic Pain, Right (Dominant) Shoulder Condition. There were three goniometric range-of-
motion (ROM) evaluations in evidence, with documentation of additional ratable criteria, which 
the Board weighed in arriving at its rating recommendation; as summarized in the chart below. 

 

Right Shoulder ROM 
(measurements in 
degrees) 

MEB ~6 Mo. Pre-Sep 

 

PT ~5 Mo. Pre-Sep 

 

VA C&P ~3 Mo. Pre-Sep 

 

Flexion (0-180) 

150 

156, 164, 160 

110 

Abduction (0-180) 

140 

135, 145, 143 

145 

Comments 

 
Neg O’Brien; neg drop-arm; 
neg cross-arm; neg 
Hawkins; anterior 
tenderness 

ROM limited by pain 

Painful motion; guarding; but 
no weakness, tenderness, 
redness; heat; subluxation 

No additional loss of motion 
with repetition 

§4.71a Rating 

10% 

10% 

10% 



 

The right hand dominant CI was first seen for right shoulder pain on 26 February 2003. He 
reported 2 months of pain which had begun after snowboarding. He was managed 
conservatively with medications and physical therapy with resolution. He was next seen 
31 March 2005 for a rotator cuff injury after playing basketball. He did not respond to 
conservative management. Magnetic resonance imaging (MRI) examination performed on 
19 June 2005 showed a labral tear and he had arthroscopic repair of the right superior anterior 
and posterior labrum. His recovery was good and he was able to deploy on 24 January 2006. 
He had recurrent pain after load bearing, though, and was found to have a recurrent rotator 
cuff tear. On 8 February 2007, he underwent a second procedure to repair his shoulder. He did 
not improve sufficiently to meet his MOS requirements and was issued a U3 profile and 
referred to MEB. The narrative summary (NARSUM) was dictated on 15 May 2007, 6 months 
prior to separation by the treating orthopedic surgeon. The CI was noted to be unable to meet 
either the requirements of his MOS or basic soldiering tasks. He was also unable to throw, lift 
heavy objects or work over head. He reported slight pain. On examination, he had anterior 
tenderness over the biceps tendon and anterior deltoid. Specific tests for impingement, 
acromioclavicular dysfunction and rotator cuff pathology were negative. He was determined to 
have non-specific right shoulder pain. The ROM is above. At the VA Compensation and Pension 
(C&P) exam performed on 23 August 2007, 3 months prior to separation, the CI reported 
weakness, morning stiffness, swelling after use, giving way, lack of endurance and numbness at 
the surgical sites. He had pain with increased activity and good relief from medications. His 
impairment was from limited lifting and repetitive motion. The scars were well healed with 
some hyper-pigmentation, but otherwise unremarkable. Movement was guarded, but there 
was no edema, effusion, weakness, tenderness, redness, heat or subluxation. The ROM is 
above. On repetitive motion, there was no additional loss in ROM, but the CI did note pain, 
weakness, and lack of endurance with pain having the greatest impact. The neurological 
examination was normal. An X-ray of the right shoulder was normal. He was diagnosed with 
right labral tear and sub-acromial bursitis and impingement status post (s/p) surgery with 
residual scars. The Board noted the CI’s contention that the medical board “should have 
reviewed the right superior labral anterior and posterior test with subacromial bursitis and 
impingement status post surgical intervention with residual scars.” This statement is, in fact, 
the C&P examiner’s assessment. The Board noted that the orthopedic surgeon who performed 
the second operation also dictated the MEB NARSUM and was a member of the MEB. The MEB 
NARSUM clearly outlines the procedures which the CI underwent. The NARSUM and MEB 
recommendation to the PEB are reviewed as part of the PEB adjudication. The Board 


determined that the medical board did perform the review for which the CI contends. The 
Board directs attention to its rating recommendation based on the above evidence. There is no 
evidence in the record that the scars interfered with the wear of military uniforms or 
equipment and the VA examination was unremarkable. There is no basis upon which to 
determine that the scars were unfitting and thus compensable. The PEB rated the shoulder at 
0%, coded 5099-5003, for pain using the USAPDA pain rule. The VA initially rated the shoulder 
at 30% for a limitation in motion not in evidence on the VA examination or any other 
examination proximate to separation. The Board determined that the VA examination and the 
MEB examinations all showed motion above the level of the shoulder. The Board also noted 
that the VA reduced the rating to 20% after separation using a second C&P examination which 
actually showed a further reduction in motion. Under code 5201, limitation of motion, motion 
above the shoulder level rates at 0%. Motion limited to the shoulder level supports a 20% 
rating. A 30% rating requires motion to be limited to midway between the side and shoulder 
level. A 10% rating is supported, though, under code 5003, degenerative arthritis, due to 
limitation of motion which is not otherwise compensable in the presence of objective findings. 
After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable 
doubt), the Board recommends a disability rating of 10% for the right shoulder condition, coded 
5099-5003. 

 

 

BOARD FINDINGS: IAW DoDI 6040.44, provisions of DoD or Military Department regulations or 
guidelines relied upon by the PEB will not be considered by the Board to the extent they were 
inconsistent with the VASRD in effect at the time of the adjudication. As discussed above, PEB 
reliance on the USAPDA pain policy for rating the right shoulder pain was operant in this case 
and the condition was adjudicated independently of that policy by the Board. In the matter of 
the right shoulder condition, the Board unanimously recommends a disability rating of 10%, 
coded 5099-5003 IAW VASRD §4.71a. There were no other conditions within the Board’s scope 
of review for consideration. 

 

 

RECOMMENDATION: The Board recommends that the CI’s prior determination be modified as 
follows, effective as of the date of his prior medical separation: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Chronic Pain, Right (Dominant) Shoulder 

5099-5003 

10% 

COMBINED 

10% 



 

 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20110927, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxx, DAF 

 President 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

(TAPD-ZB / xxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557 

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxxxx, AR20130004942 (PD201100812) 

 

 

1. I have reviewed the enclosed Department of Defense Physical Disability Board of 
Review (DoD PDBR) recommendation and record of proceedings pertaining to the 
subject individual. Under the authority of Title 10, United States Code, section 1554a, 
I accept the Board’s recommendation to modify the individual’s disability rating 10% 
without recharacterization of the individual’s separation. This decision is final. 

 

2. I direct that all the Department of the Army records of the individual concerned be 
corrected accordingly no later than 120 days from the date of this memorandum. 

 

3. I request that a copy of the corrections and any related correspondence be provided 
to the individual concerned, counsel (if any), any Members of Congress who have 
shown interest, and to the Army Review Boards Agency with a copy of this 
memorandum without enclosures. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)