RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03147
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050825

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4 (Automated Logistics Specialist) medically separated for right hip pain, rated at 0%.  

CI CONTENTION:  The applicant has asked for consideration of all conditions in her application.  Hers 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 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 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 20050608	VA* - (~2 Mos. Pre-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain...	5019	0%	Trochanteric Bursitis, Right Hip	5254-5019	10%	20050627	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 10 	
RATING:  0%	RATING:  60%	
*Derived from VA Rating Decision (VARD) dated 20050929 (most proximate to date of separation (DOS)).  

ANALYSIS SUMMARY:  

Right Hip Pain Condition.  The CI initially developed right hip pain upon a parachute landing fall which became worse while running.  Service treatment records (STR) indicated positive radiographic tests as bursitis of the right hip.  The CI was treated with physical therapy (PT), medications, rest, and injections without complete resolution of pain.  She was permanently profiled in February 2005 with chronic right hip bursitis and referred to a Medical Evaluation Board (MEB).  At the MEB narrative summary (NARSUM) examination (8 March 2005; 4 months pre-separation) the CI endorsed persistent right hip pain.  Her physical examination (PE) revealed tenderness about the right hip and mid-buttocks.  There was painful and minimal decrease in hip range-of-motion (ROM).  There was no documentation of VASRD defined periods of incapacitation.  Her diagnosis remained unchanged.  At the VA Compensation and Pension (C&P) examination (27 June 2005; two months pre-separation), the CI reported constant dull pain and stiffness to her right hip.  She endorsed the inability to sit or stand for an extended period of time.  She denied periods of incapacitation and her condition did not result in any time lost from work.  Her PE revealed minimal decrease in hip ROM of flexion and adduction with weakness, lack of endurance, and pain upon repetitive use.  The goniometric 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 ~4 Mo. Pre-Sep
(20050408) 	VA C&P ~2 Mo. Pre-Sep
(20050627) 	
Flexion (125 Normal)	120	115	
Extension (20)	15	30	
External Rotation (45)	30	60	
Abduction (0-45)	40	45	
Adduction (45)	35	25	
Comment	tenderness; painful motion 	(+) Deluca…weakness, endurance and pain	
§4.71a Rating	10%	10%	

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the hip condition at 0% under the single code of 5019 (bursitis) citing ‘acceptable parameters’ for hip ROM.  The VA rated the condition at 10% dual coded as 5254-5019 (flail hip joint-bursitis) citing painful limited ROM.  Board members agreed that absent compensable levels of ROM near the time of service separation, the presence of painful motion was sufficient to support VASRD §4.59 for a 10% rating.  Members additionally agreed that the absence of any bony abnormality such as ankylosis, fracture, or mal-union would not support any rating higher than the recommended 10%.  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 right hip condition.  

BOARD FINDINGS:  In the matter of the right hip condition, the Board unanimously recommends a disability rating of 10%, coded 5003-5019 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 her prior medical separation:  

CONDITION	VASRD CODE	RATING	
Bursitis; Right Hip	5099-5019	10%	
COMBINED	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140628, 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 XXXXXXXXXXXXXXXXXXXX, AR20160004071 (PD201403147)

1.  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, accept the Board’s recommendation to modify the individual’s disability rating to 10% without re-characterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

 BY ORDER OF THE SECRETARY OF THE ARMY:

CF: 
(  ) DoD PDBR
(  )