RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX		CASE:  PD-2014-03255
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051013

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-2 (Light Wheel Vehicle Mechanic) medically separated for “chronic pelvic pain,” rated at 0%.  

CI CONTENTION:  “Please consider all conditions.”  Her 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 20050921	VA* - (~4 Mos. Post-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pelvic Pain	5099-5022	0%	Residuals of Right Hip Stress Fracture	5252	10%	20060201	
			Residuals of Left Hip Stress Fracture	5251	0%		
Other MEB/PEB Conditions x 0	Other x 2	
RATING:  0%	RATING:  10%	
*Derived from VA Rating Decision (VARD) dated 20060329 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:  

Chronic Pelvic Pain, Right Hip.  During basic training the CI insidiously developed right hip pain in February 2005.  A bone scan revealed consistent findings of stress fractures in both upper femurs (hips).  She was treated conservatively to include medications, restrictions, ambulatory assistance, physical therapy (PT), and Occupational therapy (OT).  A repeat magnetic resonance image (MRI) conducted on 27 July 2005 (10 weeks pre-separation) revealed no acute [bony] abnormality about the right femur bone.  Due to persistent right hip pain made worse with weight-bearing activities, she was permanently profiled in August 2005 and referred to a Medical Evaluation Board (MEB).  At the time of the MEB narrative summary (NARSUM) performed on 01 September 2005 (6 weeks pre-separation), the CI’s chief complaint was “Both my hips bother me with activities.”  The physical examination (PE) revealed decreased and painful motion of the right hip.  At the VA Compensation and Pension (C&P) examination performed on 01 February 2006 (4 months post-separation), she endorsed daily right hip pain made worse with prolonged sitting and or standing.  Her PE revealed an abnormal gait and decreased/painful motion of the right hip made worse upon repetitive motion.  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.

Right Hip (Thigh) ROM
(Degrees)	MEB ~2 Mo. Pre-Sep	VA C&P ~4 Mo. Post-Sep	
Flexion (125 Normal)	113	100	
Extension (20)	-	-	
External Rotation (45)	47	-	
Abduction (0-45)	40	30	
Adduction (45)	-	-	
Comment	painful motion 	painful motion	
§4.71a Rating	10%	10%	

The Board directed attention to its rating recommendation based on the above evidence.  The PEB analogously rated the condition at 0% under the primary code of 5022 (periostits) citing an unremarkable PE.  The VA rating coded the right hip at 10% under 5252 (thigh; limitation of flexion) and cited painful motion for its rating.  Measured ROM’s were non-compensable according to VASRD criteria.  Board members agreed that sufficient evidence of painful motion was present at both pre and post Service separation examinations and therefore, in support of VASRD §4.59 maximum 10% rating.  There was no clinical evidence of ankylosis or nonunion/malunion of any component of the hip/thigh under VASRD §4.71a that would yield a rating greater than described above.  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 5099-5022 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	
Chronic Pelvic Pain, Right Hip	5099-5022	10%	
COMBINED RATING)	10%	

The following documentary evidence was considered:
Exhibit A.  DD Form 294, dated 20140515, 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, AR20160004422
(PD201403255)

1. I have reviewed the enclosed Department of Defense Physical Disability Board of
Review (000 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:
( ) 000 PDBR
( ) OVA