RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-01868
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090611

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3, Combat Medic Trainee, medically separated for “bilateral trochanteric bursitis,” rated 10% and 10%, respectfully, for a combined rating of 20%.

CI CONTENTION:  Her conditions continue to worsen and negatively impact her daily activities and the CI contends that her anxiety and back conditions were not included in the evaluation.  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 based on 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 - 20090529	VARD - 20100427	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Trochanteric Bursitis [Left 10% + Right 10%]	5019	20%	Left Hip Strain and Trochanteric Bursitis	5252	10%	20090901	
			Right Hip Strain and Trochanteric Bursitis	5252	10%	20090901	
Low Back Pain	Not Unfitting	Degenerative Disc Disease, the Lumbar Spine	5237	10%	20090901	
		Radiculopathy of the Right Lower Extremity	8520	10%	20090901	
COMBINED RATING:  20%	COMBINED RATING FOR ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:

Bilateral Trochanteric Bursitis  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral (right greater than left) hip pain condition began in August 2008 during basic training.  Radiographic evaluations in November 2008 were negative for hip pathology.  Despite treatment, the bilateral hip pain condition could not be adequately treated to meet the physical requirements of the CI’s military specialty and the CI was referred for an MEB.  The MEB forwarded “bilateral hip (right greater than left) greater trochanteric bursitis” for PEB adjudication.  The MEB NARSUM examination in March 2009 (3 months prior to separation) noted complaints of bilateral outer hip pain which worsened with all impact activities.  Physical examination showed bilateral hip tenderness to palpation and pain at the upper limited of motion.  A diagnosis of bilateral hip greater trochanteric bursitis was noted.  At the VA Compensation and Pension (C&P) examination in September 2009, performed 3 months after separation, the CI reported 3/10 bilateral hip pain.  She reported pain flare ups 1-3 times per week which was treated with Tylenol.  Physical exam showed a coordinated gait.  There was pain hip motion bilaterally with an additional 10 degrees of limitation with repetition; primarily secondary to pain.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 10% rating for each hip, coded 5019 (bursitis), citing limitation of motion of a major joint.  The VA also assigned a 10% rating for each hip, coded 5252 (thigh, limitation of flexion), based on the VA C&P examination 3 months after separation, citing painful limited motion.  There was no evidence of occasional incapacitating exacerbations, flexion of the thigh limited to 30 degrees, or abduction lost beyond 10 degrees for a higher rating.  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 bilateral hip greater trochanteric bursitis condition.

Contended PEB Condition:  Lower Back Pain.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The condition was not profiled, implicated in the commander’s statement or was not judged to fail retention standards.  There was minimal performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at separation.  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the contended condition and so no additional disability rating is recommended.

BOARD FINDINGS:  In the matter of the bilateral hip greater trochanteric bursitis condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the contended low back pain condition, the Board unanimously recommends no change from the PEB determinations as not unfitting.  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 20140311, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR Commander, US Army Physical Disability Agency
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXXXXXXXXXX AR20160011077 (PD201401868)

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 and hereby deny the individual's application.

This decision is final. The individual concerned, counsel (if any), and any Members of
Congress who have shown interest in this application have been notified of this decision by
mail.

BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure

CF:
( ) DoD PDBR
( ) DVA