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AF | PDBR | CY2013 | PD-2013-02325
Original file (PD-2013-02325.rtf) Auto-classification: Denied
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX    CASE: PD-2013-02325
BRANCH OF SERVICE: MARINE CORPS  BOARD DATE: 20141202
SEPARATION DATE: 20051130


SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an activated Reserve CPL/E-4 (0621/Field Radio Operator) medically separated for right shoulder pain. 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 referred for a Medical Evaluation Board (MEB). The shoulder condition, characterized as “sprain and strain of other specified sites of shoulder and upper arm,” and “pain in joint, shoulder region” was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E. The MEB also forwarded one other condition. The informal PEB (IPEB) adjudicated “ right shoulder superior labrum anterior and posterior (SLAP) tear, status post repair” as unfitting, rated 20%, with application of the VA Schedule for Rating Disabilities (VASRD). The PEB further adjudicated “ persistent bicipital tendonitis ” and “ shoulder pain ” as C ategory II , conditions that contribute to the unfitting condition . The CI made no appeals and was medically separated.


CI CONTENTION: “Combat related PTSD. Was not service-connected or evaluated by DOD for right knee injury, skin condition. ED associated with PTSD”.


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 shoulder pain condition is addressed below; the contended posttraumatic stress disorder (PTSD), right knee injury, skin condition or erectile dysfunction conditions were not in evidence at the time of medical separation and are not 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 Board for Correction of Naval Records.

The military Disability Evaluation System 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 (DVA), operating under a different set of laws. The Board considers DVA evidence within 12 months only to the extent that it reasonably reflects the disability at the time of separation. The Board acknowledges the CI’s contention for ratings of the various conditions noted above which were not identified by the MEB, and therefore were not adjudicated by the IPEB. Disability compensation may only be offered for those conditions that cut short the member’s career.


 RATING COMPARISON :

Service IPEB – Dated 20051028
 VA - (35 Mos. Post-Separation)
Condition
 Code Rating Condition Code Rating Exam
Right Shoulder Superior Labrum Tear, s/p Repair 5299-5003 20% Right Shoulder Bicipital Tendonitis, s/p Surgical Revision 5299-5201 10% 20081003
Persistent Bicipital Tendonitis Category II
Shoulder Pain Category II
Other x 0 (Not in Scope)
 Other x 3 20081003
Combined: 20%
 Combined: 30%
Derived from VA Rating Decision (VA RD ) dated 20081003 ( most proximate to date of separation [ DOS ] )


ANALYSIS SUMMARY:

Right Shoulder SLAP Tear, s/p Repair and Category II Conditions: The narrative summary prepared 5 months prior to separation noted that the CI injured his right shoulder while performing foot locker dips in boot camp with a subsequent injury while deployed in Iraq. He was found to have a labral tear and underwent an arthroscopic repair in January 2004. Post-operative rehabilitation did not result in any reduction of his pain and he was unable to perform within his MOS. He did note a popping in his shoulder without any snapping, clicking, or sense of instability. The final diagnoses were right shoulder SLAP tear, s/p repair, persistent bicipital tendonitis, and shoulder pain. The physical exam findings are summarized below. At the VA Compensation and Pension (C&P) exam performed 35 months after separation, the CI reported daily pain in the shoulder with flare-ups once a month that last 3 to 4 days. There was no recurrent dislocation. The physical exam findings are summarized in the chart below.

The goniometric 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.

Right Shoulder ROM (Degrees) NARSUM ~ 5 Mo. Pre-Sep VA C&P ~ 35 M os . Post-Sep
Flexion (180 Normal) 180 160
Abduction (180) 180 160
Comments : Right Hand Dominant Pos. painful motion & tenderness to palpation; No laxity; Normal strength & sensation Pos. painful motion; No instability; Pos. Deluca criiteria
§4.71a Rating 10 % * (PEB 20%) 10 % * (VA 10%)
invalid font number 31502 *IAW VASRD §4.59 Painful motion invalid font number 31502

The Board directs attention to its rating recommendation based on the above evidence. The PEB coded the right shoulder SLAP tear, s/p repair condition as 5099 analogous to 5003 (degenerative arthritis) and rated it 20%. The VA coded the right shoulder bicipital tendonitis, s/p surgical revision condition as 5299-5201 (limitation of arm motion) and rated it 10% for painful motion. Both exams performed proximate to separation documented pain limited motion without evidence of instability and no exam indicated limited ROM to a compensable level without application of §4.59 (Painful motion) or applicability of any shoulder specific VASRD code. The Board noted that the C&P exam, which was almost 3 years after separation, documented that the CI did not have any recurrent dislocations. VASRD §4.71a specifies for 5003 that satisfactory evidence of limitation of motion specifies a 10% rating for each major joint or group of minor joints affected by limitation of motion; however, the PEB applied a 20% rating. IAW DoDI 6040.44 the Board may not recommend a lower combined rating than that conferred by PEB. 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 right shoulder 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 right shoulder SLAP tear, s/p repair 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 re-characterization of the CI’s disability and separation determination.


The following documentary evidence was considered:

Exhibit A. DD Form 294, dated 20131029, w/atchs
Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans’ Affairs Treatment Record




                 
XXXXXXXXXXXXXXX
President
Physical Disability Board of Review
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 11 Mar 15

In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, 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:
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC
- XXXXXXXXXXXXXXX, former USN


                                                      XXXXXXXXXXXXXXX
                                            Assistant General Counsel
                                                      (Manpower & Reserve Affairs)

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