RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW
BRANCH OF SERVICE: ARMY
SEPARATION DATE: 20020502
NAME: XXXXXXXXXXXXXXXXX
CASE NUMBER: PD1200447
BOARD DATE: 20121214
SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this
covered individual (CI) was an active duty SPC/E‐4 (88M10/Motor Transport Operator),
medically separated for persistent right shoulder pain, status post (s/p) Weaver‐Dunn
procedure, with excision of portion of the distal clavicle. The CI’s right shoulder was injured
when the tailgate of a five‐ton truck fell on it in causing a Class III acromioclavicular (AC) joint
separation. A modified Weaver Dunn procedure was performed in November 1999 using a
screw to stabilize the distal clavicle. The screw was surgically removed in January 2000.
Despite extensive physical therapy, nonsteroidal anti‐inflammatory medications, and
subacromial steroid injection his symptoms continued without relief. The right shoulder
condition did not improve and the CI remained unable to meet the physical requirements of his
Military Occupational Specialty (MOS) or satisfy physical fitness standards. He was issued a
permanent U3 profile and initially underwent an MOS Medical Retention Board (MMRB) but
was then referred for a Medical Evaluation Board (MEB). Left knee: episodic retropatellar pain
syndrome, intermittent low back pain, and folliculitis conditions, identified in the rating chart
below, were also identified and forwarded by the MEB as meeting retention standards. The
Physical Evaluation Board (PEB) adjudicated the persistent right shoulder pain, s/p Weaver‐
Dunn procedure condition as unfitting, rated 0%, with application of the US Army Physical
Disability Agency (USAPDA) pain policy. The remaining conditions were determined to be not
unfitting and therefore not ratable. The CI made no appeals, and he was medically separated
with a 0% disability rating.
CI CONTENTION: “I have had two surgeries on my right shoulder causing numbness in my arm,
neck, and hand including loss of feeling. Have been diagnosed with PTSD through the VA.
Dislocated my left shoulder in basic training and still continues to affect me daily. Have to deal
with tinnitus on a daily basis as well. I have since had to give up many of the hobbies I was able
to do before my right arm has gotten to a point that I am always on medication which in turn
my wife and I have seen a dramatic drop in my health. I have no help from VA doctors, because
all their cures seem to be give him more meds. Prior to the above stated, I have not incurred
any problems until I was in the military when it all started or happened.”
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. Although the Board will review the ratings
for the unfitting condition, none of the other conditions requested for consideration (PTSD, left
shoulder, and tinnitus) meet the criteria prescribed in DoDI 6040.44 for Board purview. 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 20020313
Condition
Code
Rating
VA (~2 Mos. Post‐Separation) – All Effective Date 20020506
Condition
Code
Rating
Exam
Persistent Right Shoulder
Pain S/P Weaver‐Dunn
Procedure
Left Knee Episodic RPS
Low Back Pain
Folliculitis
5099‐5003
0%
Not Unfitting
Not Unfitting
Not Unfitting
S/P Weaver Dunn Right
Shoulder Repair
Patellalgia Left Knee
Low Back Pain
Folliculitis
5299‐5201
5299‐5257
5299‐5292
7899‐7806
20%
NSC
NSC
0%
20020626
20020626
20020626
20020626
20020626
↓No Addi(cid:415)onal MEB/PEB Entries↓
Combined: 0%
0% x 2 / Not Service‐Connected x 8 total
Combined: 20%
ANALYSIS SUMMARY: The Board’s authority as defined in DoDI 6040.44, resides in evaluating
the fairness of DES fitness determinations and rating decisions for disability at the time of
separation. The Board utilizes VA evidence proximal to separation in arriving at its
recommendations; and, DoDI 6040.44 defines a 12‐month interval for special consideration to
post‐separation evidence. Post‐separation evidence is probative only to the extent that it
reasonably reflects the disability and fitness implications at the time of separation.
Persistent Right Shoulder Pain, Status Post Weaver‐Dunn Procedure, with Excision of Portion of
the Distal Clavicle 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
Flexion (0‐180⁰)
Abduction (0‐180⁰)
Comments
Ortho ~2.5 Mo. Pre‐Sep
160⁰
150⁰
Well‐healed incision; markedly tender over distal clavicle;
negative piano key sign; normal subscapular push off test;
marked crepitus with motion; sensation intact in all
dermatomes; reflexes 2+ and equal bilateral upper
extremities; motor 5/5 with breakaway weakness in right
upper extremity.
NARSUM
VA C&P
~2 Mo. Pre‐Sep
~2 Mo. Post‐Sep
160⁰
125⁰
130⁰
130⁰
Tenderness to
pressure over the
surgical scar,
distal clavicle,
and acromion.
Weakness in the
right shoulder;
no sensory
defects, reflexes
normal
§4.71a Rating
20%
20%
20%
In February 2002, approximately 2 months prior to separation, the same examiner completed
both the MEB examination recorded on a DD Form 2808 and a MEB narrative summary
(NARSUM): the physical findings are recorded in the center column of the ROM chart above. X‐
rays of the right shoulder noted heterotopic ossification over the distal clavicle and calcification
over the conoid and trapezoid ligaments. At the VA Compensation and Pension (C&P) exam
completed approximately 2 months after separation, the CI reported decreased strength in his
right hand, his dominant side. However, no motor strength evaluation was documented.
The Board directs attention to its rating recommendation based on the above evidence. Both
examinations and the C&P examination document pain‐limited motion of the right shoulder at
a non‐compensable level. The PEB rated the condition analogous to VASRD code 5003,
degenerative arthritis and assigned a 0% rating based on the USAPDA pain rule. The VA rated
the condition analogous to VASRD code 5201, Arm, limitation of motion of and applied the
minimal compensable rating for this joint based on pain‐limited motion and IAW VASRD §4.59
painful motion. The CI had pain‐limited motion of his right shoulder as a residual disability after
surgical repair of his AC joint separation. He did not have arthritis. VASRD code 5203 for
clavicle or scapula, impairment of, more accurately depicts his actual disability and the Board
2 PD1200447
recommends a disability rating using code 5203. A 10% rating is warranted based on malunion
of the AC joint on the dominant side. 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 persistent right 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. As discussed above, PEB
reliance on the USAPDA pain policy for rating the persistent right shoulder pain condition was
operant in this case and the condition was adjudicated independently of that policy by the
Board. In the matter of the persistent right shoulder pain condition, the Board unanimously
recommends a disability rating of 10%, coded 5203 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:
Persistent Right Shoulder Pain
UNFITTING CONDITION
VASRD CODE RATING
5203
COMBINED
10%
10%
The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20120510, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record
SFMR‐RB
XXXXXXXXXXXXXXXXXX, DAF
President
Physical Disability Board of Review
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 XXXXXXXXXXXXXXXX, AR20130000093 (PD201200447)
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.
3 PD1200447
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 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
XXXXXXXXXXXXX
Deputy Assistant Secretary
(Army Review Boards)
CF:
( ) DoD PDBR
( ) DVA
4 PD1200447
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