RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201319 SEPARATION DATE: 20031115 

BOARD DATE: 20130219 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SPC/E-4 (71L/Postal clerk) medically separated for left 
shoulder and thoracic back pain. He was treated, but did not improve adequately to fully 
perform his military duties or meet physical fitness standards. He was issued a permanent 
profile and underwent a Medical Evaluation Board (MEB). The MEB found two conditions (left 
shoulder pain & thoracic back pain) medically unacceptable, and referred him to a Physical 
Evaluation Board (PEB). No other conditions were listed on DA Form 3947. The PEB combined 
his two problems into a single unfitting condition, and assigned a disability rating of 0%. The CI 
made no appeals, and was medically separated with 0% disability. 

 

 

CI’s CONTENTION: The CI has written a lengthy contention. It begins on DD Form 294, and is 
continued on two pages which are attached to his application. All of the comments in his entire 
written contention, were reviewed and considered by the Board. 

 

 

SCOPE OF REVIEW: The Board’s scope of review as defined in DoDI 6040.44, 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 unfitting pain conditions (left shoulder and thoracic back pain) meet 
the criteria prescribed in DoDI 6040.44, and are accordingly addressed below. No other 
conditions are within the Board’s purview. Any condition outside the Board’s defined scope of 
review may be eligible for future consideration by the Army Board for Correction of Military 
Records. 

 

 

RATING COMPARISON: 

 

Army PEB – dated 20031007 

VA – All Effective 20031116 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Left Shoulder and 

Thoracic Back Pain 

5099-5003 

0% 

Left Shoulder Pain 

5201-5010 

10% 

STR 

Thoracic Back Pain 

5242 

10% 

STR 

.No Additional MEB/PEB Entries. 

0% X 1 / Not Service Connected x 4 

STR 

Combined: 0% 

Combined: 20% 



 

 

ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed by the CI regarding 
the impairment with which his conditions continue to burden him, and the significant impact 
they have had on his quality of life. It is noted for the record that the Board is subject to the 
same laws for disability entitlements as those under which the military Disability Evaluation 
System (DES) operates. The DES has neither the role nor the authority to compensate the CI for 
future severity or potential complications of conditions. That role and authority is granted to 
the Department of Veterans Affairs (DVA). The Board evaluates DVA evidence in arriving at its 
recommendations, but its authority resides in evaluating the fairness of DES fitness and rating 
determinations at the time of separation. Compensation can only be granted for the degree of 
severity present at separation. The DVA, however, is empowered to re-evaluate a CI’s 


conditions for the purpose of adjusting the disability rating should the degree of impairment 
change. 

 

The Army PEB combined left shoulder pain and thoracic back pain into a single unfitting 
condition, coded 5099-5003 and rated at 0%. This approach by the PEB not uncommonly 
reflects its judgment that the constellation of symptoms was unfitting, and there was no need 
for separate fitness adjudications for each condition. In contrast, the VA unbundled the two 
conditions, and rated each one at 10%. The Board’s initial charge in this case was therefore 
directed at determining if the PEB’s approach of combining conditions under a single rating was 
justified in lieu of separate ratings. When considering a separate rating for each condition, the 
Board considers each bundled condition to be reasonably justified as separately unfitting unless 
a preponderance of evidence indicates the condition, standing alone, would not cause the 
member to be referred into the DES or be found unfit because of physical disability. After due 
deliberation, the Board agreed that the evidence supports a conclusion that each of the painful 
conditions, separately, would have rendered the CI unable to perform his required military 
duties. Accordingly, the Board recommends a separate disability rating for each condition. 

 

Left Shoulder Pain . In 1996, prior to joining the Army, the CI injured his left shoulder in a 
motor vehicle accident (MVA). Three years later he felt a tear in his left shoulder while doing 
push-ups. Surgical repair was twice recommended for the left shoulder but the CI declined 
both times. He was treated non-operatively with physical therapy (PT) and pain medications. 
In spite of treatment, his shoulder pain persisted and an MEB was initiated. His MEB clinical 
evaluation was on 13 August 2003. At that exam, the left shoulder had full range-of-motion 
(ROM) but shoulder motion was painful above 90 degrees. Muscle strength in both upper 
extremities was normal. As noted above, the CI was medically separated from the Army in 
November 2003. He filed a claim with the VA but he failed to appear for his examination. 
There was one ROM evaluation in evidence, which the Board weighed in arriving at its rating 
recommendation; as summarized in the chart below. 

 

Left Shoulder ROM 

MEB ~3 mos. Pre-Sep 

(20030813) 

Flexion (180° is normal) 

180° 

Abduction (180° is normal) 

180° 

Comments 

Painful above 90 degrees 

§4.71a Rating 

10%* 



 *10% based on VASRD §4.40 (Functional loss), §4.45 (The joints), and §4.59 (Painful motion) 

 

The Board carefully reviewed all evidentiary information available. Using clinical data in the 
treatment record, the CI’s left shoulder was essentially non-compensable based on the 
Veterans’ Administration Schedule for Rating Disabilities (VASRD) §4.71a codes for loss of 
shoulder/arm motion (5200 and 5201). However; IAW VASRD §4.40, §4.45, and §4.59, a 10% 
rating is warranted when there is satisfactory evidence of functional limitation due to painful 
motion of a major joint. The Board tried to find a path to a higher rating for the left shoulder, 
but there was not sufficient evidence to justify a rating higher than 10%. 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 left shoulder pain condition. It is 
appropriately coded 5299-5203 and meets criteria for the 10% rating level. 

 

Thoracic Back Pain. The CI started having back pain in 1998. Many different treatment options 
were tried including medication, PT, and manipulation. In spite of treatment, his back pain 
persisted. At the August 2003 MEB exam, the examiner detected a slight round back deformity 
of the thoracic spine and increased lumbar lordosis. There was tenderness to percussion in the 
midline at multiple thoracic levels, and rotation caused some pain in those areas. On forward 


flexion, the tips of fingers came to within 5 cm (i.e. 2 inches) of the floor. Spine X-rays showed 
minimal wedging in the T6-T10 vertebrae with early degenerative changes, and osteophytic 
lipping noted from T7-T9. There was some disk space narrowing, but no gross abnormality. 

 

The Board examined all the evidence, and directs attention to its rating recommendation based 
on the evidence above. Forward flexion was not measured in degrees. However, the Board 
concluded that since his fingers came to within 5 cm of the floor, forward thoracolumbar 
flexion was probably in the range of 80-85 degrees but not greater than 85 degrees. Internal 
rotation was painful. The examiner noted a round back deformity and increased lordosis, but 
this abnormal curvature was not due to muscle spasm or guarding. 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 thoracic back pain condition. It is appropriately 
coded 5242 and meets criteria for the 10% rating; IAW VASRD §4.40, §4.45, §4.59, and §4.71a. 

 

 

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. In the matter of the left 
shoulder pain condition, the Board unanimously recommends a disability separation rating of 
10%, coded 5299-5203 IAW VASRD §4.40, §4.45, §4.59, and §4.71a. In the matter of the 
thoracic back pain condition, the Board unanimously recommends a disability separation rating 
of 10%, coded 5242 IAW VASRD §4.40, §4.45, §4.59, and §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 

Left shoulder pain 

5299-5203 

10% 

Thoracic back pain 

5242 

10% 

COMBINED 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120702, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxx, DAF 

 Acting Director 

 Physical Disability Board of Review 

 


SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation 

for xxxxxxxxxxxxxxxxxxxxx, AR20130005367 (PD201201319) 

 

 

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 to 20% 
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 xxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)