RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03438
BRANCH OF SERVICE:  ARMY	SEPARATION DATE:  20071029

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Health Care Specialist Trainee, medically separated for “chronic left groin pain,” with a disability rating of 10%.

CI CONTENTION:  “Since my separation I have experienced pain in my pelvis, back, and sexual intercourse has not been enjoyable.”  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 based on 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 - 20071015	VARD - 20080327	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Left Groin Pain due to Left Superior Pubic Rami Stress Fracture	5099-5003	10%	Left Superior Pubic Rami Stress Fracture	5236	0%	20080126	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Left Groin Pain due to Left Superior Pubic Rami Stress Fracture.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left hip condition began in July 2007 after a physical fitness test.  Radiological (bone scan) studies on 20 August 2007, showed a left superior pubic ramus stress fracture.  At the time of the orthopedics clinic appointment on 5 September 2007, the left hip range of motion (ROM) was normal, there was no tenderness to palpation, and no pain was elicited by motion.  Despite treatment, the left hip condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for an MEB.  The MEB forwarded “left superior pubic rami stress fracture” for PEB adjudication.  At the MEB NARSUM on 5 September 2007 (8 weeks prior to separation) the CI reported continued left groin pain and was using crutches.  Physical examination showed an abnormal gait secondary to pain and the ROM had increased pain at the upper limits of all ranges.  At the time of the PT appointment on 4 October 2007, the CI reported the use of crutches as needed but was not using them that day.  The examiner reported a normal gait and full functional ROM without pain other than at the end of the passive ROM limits.  At a physical therapy (PT) appointment 2 weeks later, the CI reported a painful gait, use of crutches, and the examiner noted pain at the end of ROM limits.  

At the 26 January 2008 VA Compensation and Pension (C&P) examination, performed 3 months after separation, the CI reported that she was quite physically active at work, worked part-time at a day care center, and thought that she could walk up to a mile if needed.  Physical examination showed a normal gait.  At an additional VA examination as referenced in detail on the 28 May 2008 VA rating decision, the CI reported occasional left hip pain and pain with running.  The examiner found no evidence of pain with compression of the pelvis and full ROM.  X-rays revealed no fracture.  The examiner stated that no stress fracture was found and that the old stress fracture had healed.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic left groin pain at 10%, analogously coded 5099-5003 (arthritis, degenerative), citing the US Army Physical Disability Agency Pain Policy.  The VA rated the left groin pain at 0% coded 5236 (sacroiliac injury and weakness).  The evidence shows that the condition was essentially resolved several months prior to separation and clearly resolved 7 months after separation.  The Board found no route to a higher rating.  After due deliberation in consideration of the preponderance of the evidence, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for the chronic left groin pain condition.  

BOARD FINDINGS:  In the matter of the chronic left groin pain 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.  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 20140711, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB

XXXXXXXXXXXXXXXXX

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 XXXXXXXXXXXXXXXXXX, AR20160011343 (PD201403438)

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,
I accept the Board's recommendation and hereby deny the individual's application.
This decision is final. The individual concerned, counsel (if any), and any Members of
Congress who have shown interest in this application have been notified of this decision
by mail.

BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure

CF:
( ) DoD PDBR
( ) DVA