037RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-02037
BRANCH OF SERVICE:  MARINE CORPS 	SEPARATION DATE:  20090429

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3,  Hygiene Equipment Operator, medically separated by the Informal Physical Evaluation Board (PEB) for “left hip pain,” with a disability rating of 10%.    

CI CONTENTION:  The CI contends for anxiety, chronic pain in back, hip and knee.  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 - 20090122	VARD - 20130919	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Persistent Left Hip Pain…	5099-5003	10%	Left Hip Surgical Residuals/Thigh Impairment Aspect	5253	10%	20130716	
			Left Hip Surgical Residuals/Extension Aspect	5251	  0%	20130716	
			Left Hip Surgical Residuals/Flexion Aspect	5252	  0%	20130716	
			Left Hip Surgical Scar Residual	7805	  0%	20130716	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  80%	

ANALYSIS SUMMARY:  Persistent Left Hip Pain Condition.  

According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI underwent a left hip surgery for femoral acetabular impingement on 25 June 2008.  Following surgery further treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded left hip pain for PEB adjudication.  At the MEB NARSUM examination on 18 November 2008, the CI reported left hip pain with lateral thigh numbness. The pain was worse with to climbing stairs, flexing his hip and standing from a seated position and mild discomfort at rest He denies any weakness in his lower extremities.  The physical examination flexion to 120 degrees (normal 125), adduction to 20 degrees (normal 45 degrees, and decreased sensation to light touch (femoral nerve distribution).  Left lower extremity motor strength was normal.  The gait was normal, but slow.  At the VA Compensation and Pension (C&P) examination on 16 July 2013, performed 4 years and 3 months after separation, the CI reported persistent left hip pain.  Physical examination showed decreased and painful motion in all planes of motion with decreased left hip adduction to 20 degrees and flexion to 100 degrees.  There was an addition 5 degree decrease of flexion, extension, adduction, abduction due to pain, weakness, fatigability, and/or incoordination. 

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip condition 10% (coded 5099-5003, [analogous to degenerative arthritis]).  The VA rated the left hip condition 10% (coded 5253, [thigh, impairment of]), citing painful motion.  The VA additionally rated the left hip flexion, extension and surgical scar at 0% under codes 5251 (thigh, limitation of extension), 5252(thigh, limitation of flexion), and 7805 (scars, other) respectively.  There was no evidence of Limitation of abduction of, motion lost beyond 10 degrees or flexion limited to 30 degrees for a higher than 10% 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 left hip pain condition.  

BOARD FINDINGS:  In the matter of the left hip pain condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  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 20140506, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

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 8 Aug 16

      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:

	- XXXXXXXXXXXXXXXXXXXX, former USMC
	- XXXXXXXXXXXXXXXXXXXX, former USMC
	- XXXXXXXXXXXXXXXXXXXX, former USN
	- XXXXXXXXXXXXXXXXXXXX, former USMC
	- XXXXXXXXXXXXXXXXXXXX, former USMC
	- XXXXXXXXXXXXXXXXXXXX, former USN
	- XXXXXXXXXXXXXXXXXXXX, former USN
	- XXXXXXXXXXXXXXXXXXXX, former USN
	- XXXXXXXXXXXXXXXXXXXX, former USMC
	- XXXXXXXXXXXXXXXXXXXX, former USMC
	- XXXXXXXXXXXXXXXXXXXX, former USMC
	- XXXXXXXXXXXXXXXXXXXX, former USMC
	- XXXXXXXXXXXXXXXXXXXX, former USMC

		XXXXXXXXXXXXXXXXXXXX
	     	Assistant General Counsel
		(Manpower & Reserve Affairs)