RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 

NAME: XXXXXXXXXXXXXXXX BRANCH OF SERVICE: ARMY 

CASE NUMBER: PD1201138 SEPARATION DATE: 20021219 

BOARD DATE: 20130307 

 

 

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this 
covered individual (CI) was an active duty SGT/E-5 (31F20/Network Switching System 
Operator), medically separated for left shoulder instability. His first shoulder dislocation 
occurred in October 1999. He underwent multiple shoulder reconstructive surgeries, and 
extensive courses of physical therapy. Despite extensive management and multiple operations, 
he had persistent left shoulder instability as well as diffuse left shoulder pain and limited range-
of-motion (ROM). The condition could not be adequately rehabilitated to meet the physical 
requirements of his Military Occupational Specialty (MOS) or 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 “recurrent left shoulder instability despite operative 
management x 3” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. One 
other condition (Gastroesophageal Reflux Disease) was submitted by the MEB as meets 
retention standards. The PEB adjudicated the left shoulder condition as unfitting, rated 20%, 
citing criteria of the Veterans Administration Schedule for Rating Disabilities (VASRD). The CI 
made no appeals, and was medically separated with a 20% disability rating. 

 

 

CI CONTENTION: “Rating is not concurrent with THREE [sic] open shoulder surgeries. I am 
uncertain as to whether or not the 2 operations done at civilian surgeon’s office were even 
considered. Also, date of separation now classified as time of war. Total of 3 open-Bbankart 
surgeries, not one. Scar tissue after 3 procedures. 1st was @ Madigan Army Med Center (jun 
01) 2nd & 3rd @ Seattle Surg. Center (mar 02, jun02. Just recently had records from S.S.C. sent 
to V.A.M.C. in 2002. If they weren’t in the medical records, how were they used to determine 
disability%? Separation date of Dec 2002 was previously not classified as time of war, but now 
is. Is this Reviewable? I have always felt that being medically separated was an unfair 
classification, and I do believe that after reviewing my records/data, the classification could be 
a retirement instead, and @ the least found that 20% per surgery would be more appropriate. 
And thank you for finally looking into this, on behalf of most grieving veterans, such as myself.” 

 

 

SCOPE OF REVIEW: The Board wishes to clarify that the scope of its review as defined in 
Department of Defense Instruction (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 rating for the unfitting left shoulder condition is 
addressed below; and, no additional conditions are within the DoDI 6040.44 defined purview of 
the Board. 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 the Correction of Military Records. 

 

 

 

 

 

 


RATING COMPARISON: 

 

Service PEB – Dated 20021009 

VA (~2 Mos. Pre-Separation) – All Effective Date 20021220 

Condition 

Code 

Rating 

Condition 

Code 

Rating 

Exam 

Multi-directional Left 
Shoulder Instability, Status 
Post Open Capsular Shift 

and Bankart Repair 

5202 

20% 

Residuals Left Shoulder Surgery 

5202 

20% 

20021030 

Surgical Scarring Left Shoulder 

7804 

10% 

20021030 

Gastroesophageal Reflux 
Disease 

Not Unfitting 

Gastroesophageal Reflux 
Disease 

7346 

0% 

20021030 

.No Additional MEB/PEB Entries. 

Compression Fracture Thoracic 
Spine 

5291 

10% 

20021030 

Combined: 20% 

Combined: 40% 



 

 

ANALYSIS SUMMARY: The Board acknowledges the sentiment expressed in the CI’s application, 
i.e., that there should be additional disability assigned for conditions which will predictably 
worsen over time. It is a fact, however, 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. This role and authority is granted 
by Congress to the Department of Veterans Affairs (DVA). We note that the applicant asks the 
Board for specific correction of records and specified “Separation date of Dec 2002 was 
previously not classified as time of war, but now is. By law the Board authority is limited to 
making recommendation on correcting disability determinations.” The actual correction of 
records and consequential entitlement determinations is the responsibility of the applicable 
secretary and accounting service. The applicant's request will of course remain with the 
application as it is processed. The Board will review all evidence at hand to assess the fairness 
of PEB rating determinations, compared to VASRD standards, based on severity at the time of 
separation. 

 

Left Shoulder Instability Condition. During training in October 1999 the CI was playing football 
and landed on his, non-dominant, left shoulder which resulted in a dislocation injury. Attempts 
were made to conservatively treat with physical therapy, temporary profiles and medications 
however there was persistence of frequent dislocations, pain, limitation of motion and 
instability. Orthopedics surgically treated the shoulder instability with a Bankart repair and 
capsular shift a year after the injury. There was an uncomplicated postoperative course, 
however he continued to have frequent dislocations and subsequently underwent two surgical 
revisions without success. He remained very symptomatic reporting dislocations 15 to 20 times 
with minimal trauma to the shoulder, often awakening at night with a dislocated shoulder. 
Despite extensive rehabilitative management and multiple operations, he continued to have 
persistent left shoulder instability as well as diffuse left shoulder pain and limited ROM. The 
permanent profile limitations included; no push-ups, overhead activities, lifting, pulling, parade 
rest activity, back pack use, carrying a rifle, marching greater than 5 miles, or sit-ups. The 
commander’s statement documented that the profile limitations did not facilitate the unit's 
mission and therefore the CI was considered more of a liability than an asset. 

 

The MEB physical exam demonstrated a well-healed anterior surgical scar, diffuse tenderness 
to palpation both along the surgical site as well as the posterior shoulder, apprehension in 
bringing his shoulder to higher levels of abduction or of forward flexion, and normal upper 
extremity motor strength and sensory findings. Instability testing was not performed due 
significant guarding. X-rays revealed no evidence of current dislocation and radiolucency’s 
about the glenoid consistent with his previous surgical repairs and a small Hill-Sachs lesion. At 
the VA Compensation and Pension (C&P) exam prior to separation, the CI additionally reported 
taking nonsteroidal anti-inflammatory and narcotic medications for pain. The C&P exam 
demonstrated surgical scar tenderness otherwise no additional findings. 

 


There were two goniometric 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. 

 

Left Shoulder ROM 

(Measurements in 
Degrees) 

MEB ~ 3 Mo. Pre-Sep 

VA C&P ~ 2 Mo. Pre-Sep 

Flexion (180 Normal) 

90 

75 

Abduction (180) 

90 

50 

Comments 

Painful limited motion, 
Apprehension, significant 
guarding 

 

-- 

§4.71a Rating 

20% 

20% 



 

The Board directs attention to its rating recommendation based on the above evidence. Both 
the PEB and the VA rated the CI’s left shoulder condition at 20% coded 5202 which is consistent 
IAW VASRD §4.71a—Schedule of ratings–musculoskeletal system. The Board agreed there is no 
evidence of malunion or fibrous union of the humerus and no limited motion of 25 degrees 
from the side to consider a higher rating under the 5202 code or the 5201 code, respectively. 
The Board also considered an additional rating for residual scars after three surgeries. By 
precedent, the Board does not recommend separation rating for scars unless their presence 
imposes a direct limitation on fitness. There is no tenderness of the scar, nor functional 
uniform limitations documented on the profile and therefore the Board agreed the evidence 
does not support functional loss or ratable criteria using VASRD §4.118—Schedule of ratings–
skin. 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 instability 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 instability condition and IAW VASRD §4.71a, 
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 

Multi-directional Left Shoulder Instability, Status Post Open 
Capsular Shift and Bankart Repair 

5202 

20% 

COMBINED 

20% 



 

 

 


The following documentary evidence was considered: 

 

Exhibit A. DD Form 294, dated 20120626, w/atchs 

Exhibit B. Service Treatment Record 

Exhibit C. Department of Veterans’ Affairs Treatment Record 

 

 

 

 

xxxxxxxxxxxxxxxxxxxxxxxxx, 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 
xxxxxxxxxxxxxxxxxxxxxxxxxxxx, AR20130007814 (PD201201138) 

 

 

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 xxxxxxxxxxxxxxxxxxxxx 

 Deputy Assistant Secretary 

 (Army Review Boards)