RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03623
BRANCH OF SERVICE:  MARINE CORPS 	SEPARATION DATE:  20030115

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-5 (Logistics/Embarkation and Combat Service Support (CCS) Specialist) medically separated for pelvic/hip disability.  The condition could not be adequately rehabilitated to meet the physical requirements of her Military Occupational Specialty (MOS) or satisfy physical fitness standards.  She was placed on limited duty and referred for a Medical Evaluation Board (MEB).  “Osteitis symphysis pubis” was forwarded to the Physical Evaluation Board (PEB).  No other condition was submitted by the MEB.  The Informal PEB initially found the CI “fit” for duty.  The CI requested reconsideration.  Upon reconsideration the PEB found the CI unfit, rated 10%.  The CI made no appeals and was medically 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 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:  

Recon IPEB – Dated 20021115	VA* - (~2 Mos. Pre-Separation) 	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Osteitis Symphysis Pubis	5022-5003	10%	Public (Sic) Osteitis Symphysis 	7699-7614	NSC	20021112	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 5 	
RATING:  10%	RATING:  NSC	
*Derived from VA Rating Decision (VARD) dated 20030331 (most proximate to date of separation [DOS]).  
VARD 20040219 granted service connection for Osteitis Symphysis Pubis evaluated at 10% with an effective date of 20030116.  

ANALYSIS SUMMARY:  

Osteitis Symphysis Pubis.  The CI presented with persistent pelvic and right hip pain following childbirth in 1998.  She was diagnosed with osteitis symphysis pubis (inflammation of the pubic joint and surrounding structures) and was treated conservatively with physical therapy, activity modification and pain medications.  At the narrative summary examination the CI reported continued pelvic pain.  The physical examination was significant for reproduction of pelvic pain with direct pressure and full bilateral hip range-of-motion (ROM) except for decreased adduction.  At the VA Compensation and Pension examination performed 2 months prior to separation, the CI reported the use of a hip-pelvic belt as needed for pain.  The physical examination was significant for full bilateral hip range-of-motion with tenderness to palpation of the hips and pubis.  A physical therapy note dated 5 November 2003 documented intermittent pain relief with the use of a transcutaneous electrical stimulation unit.

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB and VA rated the chronic pelvic pain condition at 10%, coded 5022-5003 (Periostitis-degenerative arthritic) and 7699-7614 (Fallopian tube, disease, injury, or adhesions of (including pelvic inflammatory disease [PID]).  The Board considered whether the evidence supported a higher than 10% rating.  There was no evidence of muscle spasm on extreme forward bending or compensable hip limitation of motion for a higher rating.  Considering the totality of the evidence and mindful of VASRD §4.3 (reasonable doubt), members agreed that a disability rating of 10% for the chronic pelvic pain secondary to osteitis symphysis pubis condition was appropriately recommended in this case

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 osteitis symphysis pubis 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 20140725, 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 21 Dec 15

      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:

- XXXXXXXXXXXXXXXXXXXXX former USMC
- XXXXXXXXXXXXXXXXXXXXX former USMC
- XXXXXXXXXXXXXXXXXXXXX former USMC  
- XXXXXXXXXXXXXXXXXXXXX former USMC
- XXXXXXXXXXXXXXXXXXXXX former USMC
- XXXXXXXXXXXXXXXXXXXXX former USMC 

						  XXXXXXXXXXXXXXXXXXXXX
	     				  Assistant General Counsel
						  (Manpower & Reserve Affairs)