RECORD OF PROCEEDINGS 

PHYSICAL DISABILITY BOARD OF REVIEW 

 
NAME:  XXXXXXXXXXXXXXXXX                                                             BRANCH OF SERVICE:  ARMY 
CASE NUMBER:  PD1201261                                                            SEPARATION DATE:  20010925 
BOARD DATE:  20130115   
 
 
SUMMARY  OF  CASE:    Data  extracted  from  the  available  evidence  of  record  reflects  that  this 
covered  individual  (CI)  was  an  active  duty,  SPC/E-4,  (95B/Military  Policeman),  medically 
separated for right shoulder pain.  The CI reported right shoulder pain (dominant) beginning in 
September  1999  and  complained  of  intermittent  pain  with  strenuous  physical  activity.    She 
could  not  be  adequately  rehabilitated  to  meet  the  physical  requirements  of  her  Military 
Occupational Specialty (MOS).  She was authorized an alternate aerobic event to satisfy physical 
fitness standards.  She was issued a permanent U3 profile and referred for a Medical Evaluation 
Board  (MEB).    The  MEB  forwarded  no  other  conditions  for  Physical  Evaluation  Board  (PEB) 
adjudication.    The  PEB  adjudicated  the  right  shoulder  condition  as  unfitting,  rated  0%,  with 
application of the US Army Physical Disability Agency (USAPDA) pain policy.  The CI made no 
appeals, and was medically separated with a 0% disability rating.   
 
 
CI CONTENTION:  “I do still experience pain in my shoulder and knees which can prevent me 
from being as active as I would like to be.”    
 
 
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.  The other requested condition, “knees,” is 
not within the Board’s 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 service Board for Correction of Military Records. 
 
 
RATING COMPARISON:   
 

VA (6.5 Mos. Post-Separation) – All Effective Date 20010926 

Service IPEB – Dated 20010607 
Condition 
Right Shoulder Pain 

5099-5003 

Code 

Rating 

0% 

↓No Additional MEB/PEB Entries↓ 

Rating:  0% 

Condition 

R shoulder acromioclavicular 
(AC) separation 

Code 
5203 

Rating 
10% 

Not Service-Connected x 1 
Rating:  10% 

Exam 

20020410 
20020410 

 
 
ANALYSIS SUMMARY:   
 
Right Shoulder Pain Condition.  There was one goniometric range-of-motion (ROM) evaluation 
in evidence in the MEB exam, and one unelaborated VA assessment, with documentation of 

Right Shoulder ROM 

(Degrees) 

Flexion (0-180) 

Abduction (0-180) 

Comments 

§4.71a Rating 

180 

“Glenohumeral abduction 90” 

Instability & tenderness of AC joint, 

limited abduction, painful 

movement 

10%-20% (PEB 0%) 

“Full ROM when compared to the 

normal left” 

Tenderness; prominent AC joint; 

pain on extremes of ROM 

10% 

additional ratable criteria, which the Board weighed in arriving at its rating recommendation; as 
summarized in the chart below.   
 

MEB ~6 Mo. Pre-Sep 

VA C&P ~6.5 Mo. Post-Sep 

 
The  MEB  narrative  summary  (NARSUM)  in  March  2001,  6  months  before  separation,  noted 
chronic  pain  not  improved  with  physical  therapy  (PT)  and  conservative  management.    The 
service treatment record (STR) described pain with movement, weight-bearing, and overhead 
movement.  The CI had no history of dislocation, neck pain, or paresthesias in her extremities.  
An X-ray exam in October 1999 showed instability of the right acromioclavicular (AC) joint, with 
mild enlargement of the joint space with weight-bearing.  Magnetic resonance imaging (MRI) in 
October 2000 showed tendinitis.  The physical exam found tenderness of the AC joint.  The CI 
had slight pain with the cross arm test, no pain with an impingement maneuver or speed test, 
and negative piano keying and arm drop tests.  There was no apprehension with abduction and 
external rotation.  Her rotator cuff strength tests were normal.  The motor and sensory exam 
showed  no  abnormalities.    Reflexes  were  normal.    The  shoulder  exam  is  summarized  above 
with  ROM  specified  as  “Forward  flexion  180  degrees.    Glenohumeral  abduction  90  degrees.  
External rotation 90 degrees.  Internal rotation 90 degrees.”   
 
At the VA Compensation and Pension (C&P) exam in April 2002, 6 months after separation, the 
CI reported pain with overhead work.  She worked as a cashier and bank teller, and had not 
missed any work because of her right shoulder condition.  The physical exam noted a full ROM, 
without elaboration, with pain on extremes of ROM.  The physical exam noted tenderness of 
the AC joint, without swelling.  The VA rating decision cited a right AC separation in the STR in 
September 1999 (source document not found in evidence).   
The  Board  directs  attention  to  its  rating  recommendation  based  on  the  above  evidence.  
Although the MEB and VA exams were chronologically equidistant from the date of separation, 
the Board considered the MEB exam more complete and it had the higher probative value for 
rating the right shoulder at separation.  The Board discussed the MEB-stated “Glenohumeral 
abduction.”  Glenohumeral abduction is only a portion of the complete arm abduction (which 
includes, as a minimum, recruitment of the scapulo-thoracic joint) and does not directly align 
with  the  VASRD  §4.71a  ROM  measurement  and  normal  values  for  abduction  of  the  arm  in 
VASRD  Plate  I.    The  MEB-stated  ROM  was  adjudged  as  not  indicating  equivalency  to  arm 
limitation at shoulder level IAW VASRD §4.71a, code 5201 (Arm, limitation of motion of).  There 
was radiographic evidence of mild AC separation with weight-bearing.  There was no evidence 
of malunion, nonunion, or dislocation of the AC joint, or of a muscular injury to the shoulder 
girdle and arm.  The Board considered the evidence of pain-limited movement and unanimously 
agreed that this case supports a rating of 10% IAW VASRD §4.59 (painful motion) at the time of 
separation.  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 right shoulder pain 
condition, coded 5099-5203.  
 
 

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 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 right shoulder pain condition, the Board unanimously recommends a disability 
rating of 10%, coded 5099-5203 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 her prior medical separation:   
 

VASRD CODE  RATING 
5099-5203 
RATING 

10% 
10% 

           XXXXXXXXXXXXXXX, DAF 
           Acting Director 
           Physical Disability Board of Review 

Right Shoulder Pain  

UNFITTING CONDITION 

 
 
The following documentary evidence was considered: 
 
Exhibit A.  DD Form 294, dated 20120627, w/atchs 
Exhibit B.  Service Treatment Record 
Exhibit C.  Department of Veterans’ Affairs Treatment Record 
 
 
 
 
 
 
 
 
 

 

 
 
 

SFMR-RB 
 
 
 
 
MEMORANDUM FOR Commander, US Army Physical Disability Agency  
(TAPD-ZB / xxxxxxxxxxx), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557 
 
 
SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation  
for xxxxxxxxxxxxxxxxx, AR20130003046 (PD201201261) 
 
 
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 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 
 
 
 

     xxxxxxxxxxxxxxxxxxxxx 
     Deputy Assistant Secretary 
         (Army Review Boards)