RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXXX CASE: PD1201367 

BRANCH OF SERVICE: ARMY BOARD DATE: 20130424 

SEPARATION DATE: 20020221 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflect that this 
covered individual (CI) was an active duty SGT/E-5 (13B20/Cannon Crewmember) medically 
separated for a left (non-dominant) shoulder condition. He initially injured his shoulder in July 
2000 while doing physical training (PT) and then re-injured it 2 months later in a motorcycle 
accident. In January 2001, he was diagnosed with an unfused acromial ossicle (os acromiale) 
and underwent an open reduction and internal fixation (ORIF). Screws were removed in August 
2001 due to hardware-associated discomfort and the condition could not be adequately 
rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS) or 
to satisfy physical fitness standards. He was issued a permanent U3 profile and referred for a 
Medical Evaluation Board (MEB). The left shoulder condition, characterized as “chronic left 
shoulder pain status post-operative fixation of os acromiale” was forwarded to the Physical 
Evaluation Board (PEB) IAW AR 40-501 and no other conditions were submitted by the MEB. 
The PEB adjudicated the chronic left shoulder pain condition as unfitting, rated 20%. The CI 
made no appeals, and was medically separated. The CI died of a myocardial infarct on 5 June 
2011, and his case was brought to the Board by his widow. 

 

 

CI CONTENTION: “They did surgery on his Broke Shoulder. 6 months later the screws they 
placed in his shoulder started poking through his skin. They did a second surgery and removed 
the screws. Then they told him he was unfit for duty. After his surgery his left arm was never 
right again. He had troubles lifting things. He had pain in it constantly. He had other medical 
conditions he brought to their Attention, and they told him to go see the V.A. when he got out. 
The V.A. Rated him from Feb. 2002 to present for those same conditions.” [sic] 

 

 

SCOPE OF REVIEW: The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, 
paragraph 5.e.(2). It is limited to those conditions determined by the PEB to be unfitting for 
continued military service and those conditions identified but not determined to be unfitting by 
the PEB when specifically requested by the CI. The rating for the unfitting left shoulder 
condition is addressed below. No additional conditions were identified by the PEB and 
therefore any additional conditions inferred in the application are not within the DoDI 6040.44 
defined purview of the Board. Any conditions or contentions not requested in this application, 
or otherwise outside the Board’s defined scope of review, remain eligible for future 
consideration by the Board for Correction of Military Records. 

 

The Board acknowledges the information regarding the significant impairment with which the 
CI’s service-connected condition continued to burden him until the time of his death in June 
2011, but must emphasize that the Disability Evaluation System (DES) has neither the role nor 
the authority to compensate members for anticipated future severity or potential 
complications of conditions resulting in medical separation. That role and authority is granted 
by Congress to the Department of Veterans Affairs, operating under a different set of laws (Title 
38, United States Code). 

 


 

RATING COMPARISON: 

 

Service (Admin) IPEB – Dated 20020103 

VA - (12 Mos. Post-Separation) 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Chronic left shoulder 
pain 

5099-5003 

20% 

Chronic left shoulder pain, s/p 
operative fixation of os acromiale 

5003-5201 

20%* 

STR 

No Additional MEB/PEB Entries 

NSC X3 

STR 

Combined: 20% 

Combined: 40% 



Derived from VA Rating Decision (VARD) dated 20030225 

*VARD 20090326 increased rating for left shoulder to 30% effective 20020222 based on C&P examination 20030225 and 
treatment records through 2008. 

 

 

ANALYSIS SUMMARY: 

 

Chronic Left Shoulder Pain Condition. The right hand dominant CI first injured his left shoulder 
in July 2000 as he was practicing for his unit’s football competition. He then re-injured it 
approximately a month later in a fall sustained during a motorcycle accident. He began to 
experience persistent pain, exacerbated by motion, and was unable to perform push-ups, lift 
heavy objects, or raise his arm overhead. The CI was seen by orthopedics and diagnosed with 
os acromiale, or an unfused acromion (a developmental condition). After failed conservative 
therapy, surgical fixation with bone grafting was carried out in January 2001. Surgical hardware 
was removed in August 2001 due to persistent pain. Examination in the orthopedic clinic 
27 August 2001 recorded flexion of 90 degrees and abduction of 50 degrees. Despite extensive 
physical therapy and various other attempts at rehabilitation/treatment, the CI’s left shoulder 
pain did not resolve and he was referred for an MEB. The range-of-motion (ROM) evaluations 
in evidence which the Board weighed in arriving at its rating recommendation, with 
documentation of additional ratable criteria, are summarized in the chart below: 

 

 

Left Shoulder ROM 

(Degrees) 

MEB 

~4 Mo. Pre-Sep 

(20011102) 

PT 

~2 Mo. Post-Sep 

(20020422) 

PM&R 

~3 Mo. Post-Sep 

(20020606) 

VA C&P 

 ~13 Mo. Post-Sep 

(20030310) 

SSA 

~16 Mo. Post-Sep 

(20030625) 

Flexion (180 Normal) 

45 

62 

85 

30 

110 

Abduction (180) 

60 

76 

85 

30 

110 

Comments 

Limited by Pain; 
Tender over Scar; 
No Instability 

Limited by Pain 

Pain at end range 

Limited by Pain, lack 
of endurance & 
weakness 

 

§4.71a Rating 

20% 

20% 

20% 

20% 

10% 



 

At the MEB narrative summary (NARSUM) evaluation 2 November 2001, 4 months prior to 
separation, the CI complained of left shoulder pain and exhibited tenderness to palpation as 
well as muscle atrophy and weakness in the rotator cuff. There was no evidence of instability. 
Active flexion was 45 degrees and active abduction was 60 degrees (passive flexion 75, passive 
abduction 100). Radiographs obtained at the time of the NARSUM examination showed 
“healing os acromiale [and] no … degenerative joint disease.” A VA physical therapy 
assessment performed on 22 April 2002, 2 months after separation, documented that the CI 
had reported ROMs of approximately 90 degrees in December 2001 but worsened since 
stopping physical therapy. On examination, flexion was 62 degrees and abduction was 76 
degrees. Atrophy of musculature was noted. An examination in the physical medicine and 
rehabilitation (PM&R) clinic on 6 June 2002 reported flexion and abduction of 85 degrees with 
pain at end range. A magnetic resonance imaging of his left shoulder on 19 August 2002 
demonstrated some post-operative changes associated with the acromioplasty, but no tears of 
the rotator cuff or labrum and no glenohumeral joint pathology. At the VA Compensation and 
Pension (C&P) examination 10 March 2003, 13 months after separation, the CI reported left 
shoulder pain and stated that he had been “functionally impaired as he [could not] move 


properly, bear weight, or sleep on the left side.” The examiner reported tenderness and spasm 
over the surgical site atrophy of the deltoid muscle. Active flexion was 30 degrees, active 
abduction was 30 degrees, and active internal rotation and external rotation were also 30 
degrees each. The examiner referred to the limitation of motion as unfavorable ankylosis. 
There were no reported neurovascular abnormalities. Radiographs of the left shoulder 
performed at that time showed no evidence of bony anklyosis and were essentially 
unremarkable, excepting the residuals of the surgery at the acromioclavicular joint. 
Approximately 2 months later at a social security disability evaluation, 25 June 2003, 
examination of the CI’s left shoulder demonstrated flexion and abduction of 110 degrees. The 
examiner concluded that there were “no functional impairments except [the CI could not] raise 
left upper extremity above his head.” 

 

The Board directs attention to its separation rating recommendation based on the above 
evidence. Both the PEB and the VA rated the left shoulder condition 20% citing limitation of 
motion based on evidence proximate to the date of separation. The Board noted that the CI 
had multiple examinations bracketing the time of his separation, and his recorded left shoulder 
ROM fluctuated somewhat during this time, as can be typically expected between various visits 
and healthcare providers. The MEB NARSUM examination and two examinations in the several 
months after separation demonstrated the similar functional deficits and ROM consistent with 
the 20% rating for limitation of arm motion (minor, non-dominant). The Board noted the C&P 
examination 13 months after separation wherein the examiner termed the worsened limitation 
of motion unfavorable anklyosis. However there was no objective evidence of ankylosis on 
imaging examinations and another examination 2 months later documented limitation of 
motion at the shoulder level. The Board considered the VA’s later determination that the CI’s 
left shoulder condition warranted a 30% rating however, it saw no indication in treatment 
records surrounding the time of discharge that the PEB’s assessment of the CI’s disability was 
incorrect. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 
(reasonable doubt), the Board concluded that there was insufficient cause to recommend a 
change in the PEB adjudication for the left shoulder pain condition. 

 

 

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. The Board did not 
surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD 
were exercised. In the matter of the left shoulder condition, the Board unanimously 
recommends no change in the PEB adjudication. There were no other conditions within the 
Board’s scope of review for consideration. 

 

 

 


RECOMMENDATION: The Board therefore recommends that there be no recharacterization of 
the CI’s disability and separation determination, as follows: 

 

UNFITTING CONDITION 

VASRD CODE 

RATING 

Chronic Left Shoulder Pain 

5099-5003 

20% 

COMBINED 

20% 



 

 

The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120624, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

 

 xxxxxxxxxxxxxxxxxxxxxxxx, DAF 

 Director of Operations 

 Physical Disability Board of Review 

 


 

 

 

 

SFMR-RB 


 

 

MEMORANDUM FOR Commander, US Army Physical Disability Agency 

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

 

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation for 
xxxxxxxxxxxxxxxxxxxxxxx, SSN 002-58-5007, AR20130011094 (PD201201367) 

 

 

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 and hereby deny the individual’s application. 

This decision is final. The individual concerned, counsel (if any), and any Members of Congress 
who have shown interest in this application have been notified of this decision by mail. 

 

 BY ORDER OF THE SECRETARY OF THE ARMY: 

 

 

 

 

Encl xxxxxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)