RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	     CASE:  PD-2014-00554
BRANCH OF SERVICE:  AIR FORCE                                                          SEPARATION DATE:  20070309	

Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty, E4, Integrated Avionics Systems Journeyman, medically separated for “chronic right hip pain,” with a disability rating of 20%. 

CI CONTENTION:  The CIs conditions continue to worsen and negatively affect his daily life.  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB – 20070119	VARD - 20070604	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain 	7199-7121	20%	Congenital Right Hip Dysplasia	5003-5255	20%	20070518	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Chronic Right Hip Pain.  In 2004, while deployed overseas, this CI had onset of right hip pain.  In 2005, during a subsequent deployment, the pain became increasingly more severe.  Radiologic imaging in November 2005 showed evidence of congenital hip dysplasia.  He was treated with physical therapy (PT), oral medication, steroid injections, and other therapeutic measures.  In spite of all treatment efforts, his hip pain persisted and a Medical Evaluation Board (MEB) was initiated.  The MEB narrative summary (NARSUM) was dated 18 September 2006.  The CI reported that his physical activity was restricted due to his hip condition.  
He was able to perform most aspects of his job, but work activities exacerbated the hip pain.  On 28 November 2006, the CI had a clinical follow-up visit with orthopedics.  Physical examination (PE) of the right hip revealed considerably decreased internal and external rotation, and somewhat decreased flexion.  Neurovascular was intact, and the musculoskeletal compartments were soft.  The examiner’s diagnostic assessment was: “chronic right hip pain, secondary to hip dysplasia.”

The CI separated from service on 9 March 2007.  Two months later, on 18 May 2007, he presented for a VA Compensation and Pension (C&P) examination.  He reported daily pain in the right hip.  The pain was worse after a very active day.  He denied dislocation or subluxation.  He had not missed any time from work due to hip pain, and denied any problems with doing activities of daily living (ADLs).  He could walk half a mile before the pain would ensue.  On PE, the CI walked with the slightest of antalgic gaits.  He was able to sit down, lie down, sit up, stand up, dress, and undress without significant hip pain.  

The Board directed attention to its rating recommendation based on the evidence.  The PEB and the VA chose different coding options for the right hip condition, but both assigned a 20% disability rating.  The Board determined that the May 2007 C&P examination was just 10 weeks after separation, and therefore had significant probative value.  At that examination, the CI had the slightest of antalgic gaits.  He was able to sit down, lie down, sit up, stand up, dress, and undress without significant hip pain.  ROM testing of the right hip showed 80 degrees of flexion, and 35 degrees of abduction.  The Board determined that, at separation, the CI’s hip disability was best described as “moderate.”  There was insufficient evidence in the record to justify describing the hip disability as “marked.”  Therefore, IAW VASRD §4.71a, a disability rating of 20% was appropriate for the right hip condition.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board found insufficient cause to recommend a change in the PEB adjudication of the unfitting right hip condition.  

BOARD FINDINGS:  In the matter of the Chronic right hip pain, 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.  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 20140121, with attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MR
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

Dear XXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2014-00554.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

Attachment:
Record of Proceedings