RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXX	CASE:  PD-2014-02489
BRANCH OF SERVICE:  MARINE CORPS 	SEPARATION DATE:  20030531

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-1 (Basic Marine) medically separated for a left hip condition.  The left hip condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS).  He was placed in the Recruit Separation Platoon with a “no duty” status recommended pending separation and referred for a Medical Evaluation Board (MEB).  “Stress fracture left hip, compression side” was forwarded to the Physical Evaluation Board (PEB) IAW SECNAVINST 1850.4E. No other condition was submitted by the MEB.  The Informal PEB adjudicated “stress fracture left hip, compression side” as unfitting, rated 20%, with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was separated.  

CI CONTENTION:  The CI requests the Board consider all conditions.  His complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e. (2).  It is limited to those conditions determined by the 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/Naval 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 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:  

IPEB - Dated 20030410	VA* - (~3 Mos. Post-Separation) 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Stress Fracture Left Hip, Compression Side	5003-5255	20%	Femoral Neck Stress Fracture, Left	5299-5255	10%	20030911	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 1 	
RATING:  20%	RATING:  10%	
*Derived from VA Rating Decision (VARD) dated 20031002 (most proximate to date of separation [DOS]).  

ANALYSIS SUMMARY: 

Stress Fracture Left Hip, Compression Side.  The CI presented with left hip pain on 21 February 2003.  A bone scan performed 24 February 2003 demonstrated a left femoral neck stress fracture.  The CI was treated with crutch ambulation and anti-inflammatory medication.  The narrative summary (NARSUM) noted physical findings from an orthopedic examination of an antalgic gait and painful motion.  At the VA Compensation and Pension (C&P) examination performed approximately 3 months after separation, the CI reported mild left hip pain.  On physical examination there was pain with internal rotation and mild tenderness to palpation.  The goniometric 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.

Left Hip (Thigh) ROM
(Degrees)	MEB ~2.5 Mo. Pre-Sep	
ORTHO ~2 Mo. Pre-Sep	VA C&P ~3 Mo. Post-Sep	
Flexion (125 Normal)	Tolerate to 90	Some discomfort with full flexion only	125	
Extension (20)			20 (30)	
External Rotation (45)	Did not tolerate		45 (60)	
Abduction (0-45)			45	
Adduction (45)			25	
Comment	Antalgic gait; positive Trendelenburg on left	
Painful motion	Painful motion	
§4.71a Rating	20%	10%	10%	

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip condition 20%, coded 5003-5255 (degenerative arthritis-femur impairment of, moderate).  The VA rated the condition 10%, coded 5299-5255 (analogous to femur impairment of, slight).  The Board considered whether the evidence supported a higher than 20% rating.  The Board determined that the evidence did not support a higher rating for marked hip disability.  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 condition.  

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.  In the matter of the stress fracture left hip condition 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.  

RECOMMENDATION:  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 20140528, 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 Jan 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:

- XXXXXXXXXXXXXXX, former USN 
- XXXXXXXXXXXXXXX, former USN 
- XXXXXXXXXXXXXXX, former USN   
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC 
- XXXXXXXXXXXXXXX, former USN  
- XXXXXXXXXXXXXXX, former USN 
- XXXXXXXXXXXXXXX, former USN 
- XXXXXXXXXXXXXXX, former USN 
- XXXXXXXXXXXXXXX, former USN 
- XXXXXXXXXXXXXXX, former USMC 
- XXXXXXXXXXXXXXX, former USMC 
- XXXXXXXXXXXXXXX, former USN
- XXXXXXXXXXXXXXX, former USMC 

				XXXXXXXXXXXXXXX
	     			Assistant General Counsel
				(Manpower & Reserve Affairs)