RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE:  PD-2014-03548
BRANCH OF SERVICE:  Army		SEPARATION DATE:  20030517

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4, Infantryman, medically separated for “left hip pain” with a disability rating of 10%.

CI CONTENTION:  The applicant contends that his rating is too low.  His 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 upon a 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 - 20030313	VARD - 20030602	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Hip Pain…	5253	10%	Chronic Left Hip Pain…	5299-5252	10%	20030416	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Left Hip Pain.  The service treatment record (STR) and Medical Evaluation Board (MEB) narrative summary (NARSUM) documented a groin injury in 2000 while playing basketball.  Surgery was performed in December 2001 for removal of bony fragments and reattachment of the adductor muscle tendon.  Following surgery further treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “left hip pain and status post primary repair of adductor avulsion and excision of heterotopic ossification” for PEB adjudication.

The MEB NARSUM examination was performed on 30 December 2002 (5 months pre-separation).  The CI reported pain and inability to perform sit-ups, run, jump, climb, squat, or stand for prolonged periods.  The physical examination showed range of motion (ROM) of flexion to 90 degrees (normal 125), extension 10 (20), abduction 40 (45), and external rotation (“out toe”) to 15 (45).  At the MEB examination (documented on DD Forms 2807-1 and 2808) dated 19 January 2003 (4 months pre-separation), the CI reported inability to run, jump, or flex the hip to the chest.  The physical examination showed tenderness of the left groin.

At the VA Compensation and Pension (C&P) examination dated 16 April 2003 (1 month pre-separation), the CI reported intermittent pain worsened by prolonged walking, climbing stairs, bending, and running with inability to squat or jump.  He denied use of assistive devices.  The physical examination showed a normal gait, no muscular atrophy, and pain on light palpation of the groin.  The ROM was flexion to 90 degrees, extension 10, abduction 40, and external rotation 15; all with pain.  Repetition resulted in decreased ROM as follows: flexion to 75 degrees, extension 5, and external rotation 10.

The Board directed attention to the rating recommendation based on the above evidence.  The PEB rated the left hip condition 10% coded 5253 (thigh, impairment) citing limitation of motion (cannot out toe).  The VA also rated the left hip condition 10% analogously coded 5299-5252 (thigh limitation of flexion), based on the VA C&P examination 1 month before separation, citing painful limited motion.

The Board considered the evidence for a higher rating.  There was no evidence of ankylosis (5250), or flexion limited to 30 degrees (5252) in support of a higher rating.  There was no evidence of limitations in abduction (motion lost beyond 10 degrees), or adduction (inability to cross legs), in support of a higher rating under 5253.  There was documentation of limited rotation (cannot toe out more than 15 degrees) in support of 10% rating under 5253.  Application of VASRD §4.59 (painful motion), §4.40 (functional loss), §4.45 (the joints) was supported by documentation (painful motion and mechanical limitations of the hip) for a 10% rating coded as 5299-5253.  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:  In the matter of the 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.  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 20140717, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

21 NOV 2016

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
, AR20160017511 (PD201403548)

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.

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA