I am not really sure where to begin here so please bare with me.

I have a short box W150 with a Dana 60 swap in the rear and GM 8-lug/disc brake knuckle swap on the D44 up front. It has a 4" all spring tough county lift and 33x11.50 tires. So far I have blown up two constant velocity joints in the front drive line. The last time it happened the drive shaft took out the passenger side exhaust and almost stranded us in BFE on in a remote canyon between two mountains. After this experience I have decided that CV joints are unreliable. \

I never really gave much thought to the why's of Dodge using the CV joint in the front drive line until I started considering that the t-case yoke angle had to point up in in order for the rest of the engine/trans/t-case to be down tilted for the rear drive line. Do I have a chance in hell of making this work without a CV joint or swapping in a 203 t-case? It looks like if I shim the t-case mount to get the front yoke angle level or the rear output from the t-case will also be level. FWIW from the factory it measures 3 deg positive vs the +2 deg on the front diff yoke. I am kind of stumped here. Am I missing something when it comes to making the CV joint last in this application?

Sorry for the likely confusing, long post but I am kind of at a loss here.

I have an 80' W-150 shortbox with a 208 with a 6" super lift and I had to clearance the CV in some areas to prevent it from coming in contact which prolly would have exploded otherwise

You should not have any problem with the driveshaft with a 4" lift. Either the ujoints were wore out, or like said, some areas need clearanced when the angle gets steeper.
I have ran much more lift than that without trouble. A 203 transfer case also uses a cv, so you won't gain anything there.
If you are out in bfe, it is always a good idea to carry extra ujoints, and or even an extra driveline.

Can the pinion shims be used on the front axles, or will that cause issues with alignment?

Believe 65-93 all use the same style front just hehe odd units ds is longer and D60 front setups are shorter than 44s

Yeah that's suppose to be 75-93 but my big fingers and little buttons on my phone

Clearance the cv setup. If that don't work or isn't your real problem Id upgrade to a 205.

Your 208 is not the problem. The problem is front drive shaft angle. The C/V joints job is to lessen the the angle of front output flange, the 2 degrees up you referred to. Each u joint in the C/V halves the drive shaft upper angle. The problem is the small u joints and that the manufacturer of those C/V s never intended it to deal with the lift / angle. The best way to take care of this problem is buy a high angle c/V joint. Problem gone or you can spend money on all kinds of things that will not take care of the problem. Tom woods, high angle drive shaft or others. You must get one rated for more angelarity.