RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

       BRANCH OF SERVICE:  MARINE CORPS 
   
SEPARATION DATE:  20020915 

 
NAME:  XX 
CASE NUMBER:  PD1200574 
BOARD DATE:  20130307 
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered individual (CI) was an active duty LCpl/E-3 (2146/Main Battle Tank Mechanic), who was 
medically separated for a left shoulder labral tear condition.  The CI injured his left shoulder 
while  lifting  a  heavy  object.    After  conservative  treatment,  the  CI’s  left  shoulder  labral  tear 
condition could not be adequately rehabilitated to meet the physical requirements of his MOS.  
He was consequently placed on limited duty for his left shoulder condition and referred for a 
Medical Evaluation Board (MEB).  A left upper extremity radial nerve palsy (resolving) condition 
was  identified  by  the  MEB  and  also  forwarded  for  consideration  by  the  Physical  Evaluation 
Board (PEB).  The PEB adjudicated the left shoulder labral tear condition as unfitting, rated 10%, 
citing criteria of the Veterans Administration Schedule for Rating Disabilities (VASRD).  The CI’s 
left upper extremity radial nerve palsy condition was determined to be Category III:  conditions 
that are not separately unfitting and do not contribute to the unfitting condition.  The CI made 
no appeals, and was medically separated with a combined 10% permanent disability. 
 
 
CI CONTENTION:  “The original discharge only dealt with the direct effects of the single shoulder 
injury  that  could  not  be  treated.  The  discharge  did  not  take  into  account  my  entire  medical 
record.  My medical record contains diagnosis for 5 separate [sic] issues that all occurred during 
my  service.    Left  shoulder  injury,  left  radial  nerve  palsy,  left  and  right  knee  injuries  and 
contracting mononucleosis.  These all resulted in a VA disability rating of 60%.” 
 
 
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 conditions “identified but not determined 
to be unfitting by the PEB.”  The rating for the CI’s unfitting left shoulder labral tear condition is 
addressed below.  The requested left upper extremity radial nerve palsy condition which was 
determined  to  be  not  unfitting  by  the  PEB,  is  likewise  addressed  below.    The  CI’s  remaining 
contended conditions of bilateral knee injuries and mononucleosis were not addressed by the 
PEB and therefore are not within the 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 Board for Correction of Naval Records. 
 

 

RATING COMPARISON:   
 

Service IPEB – Dated 20020711 
Condition 

Code 

Rating 

Left Shoulder Labral Tear 

5299-5003 

10% 

Left Upper Extremity 
Radial Nerve Palsy. 
Resolving 

↓No Additional MEB/PEB Entries↓ 

VA (1 Mo. Pre-Separation) – Effective 20020916 
Condition 

Rating 

Code 

Exam 

5299-5201 

20% 

20020822 

Left Shoulder Sprain with 
Residuals, Status Post Labral 
Tear 

Not Unfitting 

Left Wrist Radial Nerve Palsy 

8599-8514 

20% 

20020822 

Right Knee Patellofemoral Pain 
Syndrome 
Left Knee Patellofemoral Pain 
Syndrome 
Mononucleosis 

10% 
10% 
Right Shoulder Condition Not Service Connected x 1 

5299-5260 
6399-6354 

5299-5260 

10% 

20020822 

20020822 
20080822 
20020822 

Combined:  10% 

Combined:  60% 

 
 
ANALYSIS SUMMARY:   
 
Left Shoulder Labral Tear Condition.  The CI is right hand dominate.  The CI sustained a lifting 
injury in December 1999.  The condition was suspected by a magnetic resonance imaging (MRI) 
exam on 27 February 2001.  Orthopedic evaluation 4 Apr 2001 cited “Type I (Superior Labral 
Tear from Anterior to Posterior) SLAP, if patient not improving possible A-scope debridement.”  
By 16 January 2002, and MRI diagnosed the condition as “Anterior-inferior labral tear noted.”  
The CI’s treatment consisted of physical therapy, which made his symptoms worse.  Orthopedic 
surgery consultants did not recommend injection or surgical treatment.  On 15 April 2002, a 
medical board statement of patient findings cited limitations of “no running, push-ups, pull-ups, 
or lifting greater than 15 pounds with the left upper extremity.”  The commander’s non-medical 
assessment  (NMA)  May  2002,  noted  “In  my  opinion  (the  CI)  suffers  from  a  shoulder  injury 
prohibits him from performing all aspects of his MOS.”  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 

(In degrees) 
Flexion (0-180) 

Abduction (0-180) 

Comments 

§4.71a Rating 

MEB ~5 Months Pre-Separation 

VA C&P ~1 Month Pre-Separation 

170 
160 

Stable; negative apprehension, 

relocation, Jobe test, slide and biceps 

provocation tests (see text) 

10%* (PEB 10%) 

180 
180 

Pain with motion; tenderness; trace crepitus, 
intermittent popping; mild laxity (see text) 

10%-20% (VA 20%) 

* Conceding painful motion   
 
The  orthopedic  surgeon  who  did  the  narrative  summary  (NARSUM)  5  months  prior  to 
separation noted “he has had recurrent anterior as well as posterior left shoulder pain” and 
“Currently, the patient is unable to run any significant distance without left shoulder pain and 
muscle spasm.”  In addition to the above ROM, the orthopedist found “The shoulders are stable 
and  a  negative  apprehension  test  is  seen  bilaterally,  as  well  as  a  negative  relocation  test.  In 
addition, the Jobe test, slide, and biceps provocation tests are negative.  Both upper extremities 
are neurovascularly intact to motor and sensory testing.”  The examiner stated “The patient is 
unable to run any significant distance without left shoulder pain and muscle spasm.”  At the VA 
Compensation and Pension (C&P) exam a month prior to separation, the examiner noted the CI 
“states  he  is  unable  to  rotate  his  shoulder  because  of  popping  and  pain.    He  has  difficulty 
lifting/carrying and moving his shoulder.”  The VA exam is summarized above and the examiner 
stated “There is some intermittent popping sensation of the shoulder and some mild laxity of 

2                                                           PD1200574 

the  ligaments  in  the  left  shoulder.    ROM  of  the  left  shoulder  is  limited  by  pain,  fatigue  and 
weakness.”   
 
The Board directs attention to its rating recommendation based on the above evidence.  The 
PEB coded analogously to 5299-5003 for arthritis and rated it for painful motion at 10%.  The 
Board noted the VA coded analogously for 5299-5201, arm, limitation of, and assigned a minor 
side (non-dominant side) rating of 20%.  The Board noted the more proximate timing of the VA 
C&P exam and the disability rating importance of the examiner’s finding of “Range of motion of 
the left shoulder is limited by pain, fatigue and weakness.”  However, the exam did not specify 
that arm motion was limited by any specific value, or functionally limited to the “at shoulder 
level”  to  support  a  20%  rating  under  code  5201  criteria.    The  Board  considered  analogous 
muscle coding IAW VASRD §4.73, to reflect the functional loss cited by the VA examiner, such as 
5303 (Group III) or 5304 (Group IV) which involve the shoulder functions.  The Board adjudged 
that  the  disability  picture  did  not  reasonably  support  rating  at  the  “moderate”  (20%)  level.  
Given the consistently near-normal and normal ROM findings of both the C&P and MEB exams 
the Board majority adjudged that the PEB rating of 10% most accurately represented the CI’s 
disability  under  code  5299-5003  for  a  non-dominant  shoulder.    After  due  deliberation, 
considering  all  of  the  evidence  and  mindful  of  VASRD  §4.3  (reasonable  doubt)  and  §4.40 
(functional loss), the Board majority concluded that there was insufficient cause to recommend 
a change in the PEB adjudication of the left shoulder labral tear condition. 
 
Left Upper Extremity Radial Nerve Palsy, Resolving Condition.  The Board’s main charge with 
respect to this condition is an assessment of the fairness of the PEB’s determination that it was 
not unfitting.  The Board’s threshold for countering fitness determinations is higher than the 
VASRD  §4.3  (reasonable  doubt)  standard  used  for  its  rating  recommendations,  but  remains 
adherent to the DoDI 6040.44 “fair and equitable” standard.  The left upper extremity radial 
nerve palsy condition (hand and wrist symptoms) was part of the CI’s limited duty profile but 
was not specifically implicated in the commanding officer’s NMA.  Although the condition was 
forwarded  by  the  MEB,  the  service  treatment  record  (STR)  shows  the  member  had  normal 
nerve conduction and electromyogram studies, and the condition had been splinted and was 
improving.  The SF 88 physical, 4 months prior to separation (a month after the MEB) noted left 
arm flexion of 4/5 (decreased strength) and rapid alternating movements (RAMs) as inefficient.  
The prior to separation VA exam indicated mild to moderate findings of decreased fine motor 
coordination in the left hand with 4/5 muscle weakness, decreased sensations along the lateral 
aspect of the left hand involving the first and second fingers.  The left radial nerve palsy was 
reviewed  by  the  action  officer  and  considered  by  the  Board.    There  may  have  been  overlap 
between the disability picture of the shoulder labral tear and the symptoms of the radial nerve 
palsy (wrist and hand symptoms).  However, the CI was right-handed and there was no clear 
performance based evidence from the record that the left upper extremity radial nerve palsy 
condition significantly interfered with satisfactory duty performance.  After due deliberation in 
consideration  of  the  preponderance  of  the  evidence,  the  Board  concluded  that  there  was 
insufficient cause to recommend a change in the PEB fitness determination for the left upper 
extremity radial nerve palsy condition thus no additional disability rating can be recommended. 
 
 
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 labral tear condition and IAW VASRD §4.71a, 
and by a vote of 2:1, the Board recommends no change in the PEB adjudication.  The single 
voter  for  dissent  who  recommended  20%  under  code  5299-5201  did  not  elect  to  submit  a 
minority  opinion.    In  the  matter  of  the  left  upper  extremity  radial  nerve  palsy,  resolving 

3                                                           PD1200574 

condition, the Board unanimously recommends no change from the PEB determination as not 
unfitting.  There were no other conditions within the Board’s scope of review for consideration. 
 
 
RECOMMENDATION:  The Board recommends that there be no recharacterization of the CI’s 
disability and separation determination, as follows:   
 

Left Shoulder Labral Tear Condition 

UNFITTING CONDITION 

VASRD CODE  RATING 
5299-5003 
COMBINED 

10% 
10% 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120513, w/atchs. 
Exhibit B.  Service Treatment Record. 
Exhibit C.  Department of Veterans Affairs Treatment Record. 
 
 
  
 
 
 
 
 
 

 
 
 

 

xx 
Acting Director 
Physical Disability Board of Review 

4                                                           PD1200574 

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW  
                                        BOARDS  

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS 

Ref:   (a) DoDI 6040.44 

             (b) CORB ltr dtd 22 Mar 13 
 

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for 
the reasons provided in their forwarding memorandum, approve the recommendations of the 
PDBR that the following individual’s records not be corrected to reflect a change in either 
characterization of separation or in the disability rating previously assigned by the Department of 
the Navy’s Physical Evaluation Board: 
 
 
 

 
 

 

 

     
 
 
 
 

-   former USMC 
-   former USN  
-   former USMC 
-   former USMC 
-   former USN  
-   former USMC 
-   former USMC 
  

 
      
 

 
 
 

 
 
 

 
 
 

 
 
 

  xx 
  Assistant General Counsel 
     (Manpower & Reserve Affairs) 

5                                                           PD1200574