RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-02032
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060119

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E6, Broadcast Journalist,  medically separated for “right hip arthritis,” with a disability rating of 0%.

CI CONTENTION:  The CI contended for hemorrhoids, a mental health condition and cough due to burn pit exposure.  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 - 20051003	VARD - 20080301	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Arthritis	5010	0%	Residual, Fracture of Right Hip	5255	0%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Right Hip Arthritis.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent right hip reduction surgery in February 2002 for a femoral neck fracture suffered from a motor vehicle accident.  Despite surgical pinning and aggressive rehabilitation, the right hip pain continued and he could not be adequately rehabilitated to meet the physical requirements of his military specialty and therefore, was referred for an MEB.  At the MEB NARSUM, 22 April 2005 (9 months before separation), the CI reported continued right hip pain.  The MEB physical examination noted tenderness and decreased painful motion of the right hip.  There was a right-sided antalgic gait.  

In regards to the VA Compensation and Pension (C&P) examination, the original VA rating decision noted “Failure to provide the results of a VA examination” under the evidence category.  Therefore the Board’s final rating recommendation will be based upon the NARSUM as well as applicable service treatment encounters within the case file.  The permanent profile listed right hip post-traumatic arthritis as the sole diagnosis.  The 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 Hip (Thigh) ROM
(Degrees)	
MEB ~7 Mo. Pre-Sep
	
Neuro ~19 Mo. Post-Sep
	
Flexion (125 Normal)	120	normal ROM	
Extension (20)	5		
External Rotation (45)	25		
Abduction (0-45)	35		
Adduction (45)	25		
Comment	painful motion	tenderness	
§4.71a Rating	10% 	0% 	

The Board directed attention to its rating recommendation based on the above evidence.  The PEB and VA chose different coding options for the hip, although both arrived at the same 0% rating.   The PEB used code 5010 (traumatic arthritis) whereas the remote VA examination (19 months after separation) used code 5255 (femur impairment).  All Board members agreed that examination probative value be apportioned to the MEB due to the nearer time reference to separation.  The limited extension of 5 degrees supported a maximum of 10% impairment.  Absent persistent fracture without nonunion or malunion and or the presence of hip disability greater than ‘slight’, there was no route to an impairment rating higher than ROM based 10%.  There was no coexistent pathology which would merit additional rating for the hip condition under any other separate code.  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 left hip condition, coded 5251.

BOARD FINDINGS:  In the matter of the right hip condition, the Board unanimously recommends a disability rating of 10%, coded 5251 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.    The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Status Post Right Hip Fracture 	5251	10%	
COMBINED	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140502, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20160007473, XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board's recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay. A copy of this decision will be filed with your Physical
Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.

This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,

XXXXXXXXXXXXXXXXXXX
Deputy Assistant Secretary of the Army

Enclosure