RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX		CASE:  PD-2014-03697
BRANCH OF SERVICE:  Army		SEPARATION DATE:  20030415

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E6, Infantryman, medically separated for “chronic pain…from pelvic fractures…,” with a disability rating of 0%.

CI CONTENTION:  “Head injury from accident has worsened recently diagnosed TBI, seizure disorder.”  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 - 20030213	VARD- 20060303	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain…Pelvic Fractures…	5099-5003	0%	Residuals…Pelvic Fracture…	5010	10%	20050819	
COMBINED RATING:  0%	COMBINED RATING FOR ALL VA CONDITIONS:  70%	

ANALYSIS SUMMARY:

Pelvic Pain.  According to the service treatment record and Medical Evaluation Board (MEB narrative summary (NARSUM), on 22 January 2002 the CI was in a motorcycle accident.  He sustained an open fracture of the pelvis (separation of the pubic symphysis, an anterior ramus fracture, and sacral fracture) and received surgery on 28 January 2002.  He underwent rehabilitation in physical therapy, but was unable to return to full duty due to pain.  X-rays of the hips on 31 October 2002 showed expected post-surgical changes.  Lumbar spine X-rays the next day also showed the post-surgical changes, but no evidence for spine or disc disease.  During an orthopedic examination on 6 November 2002, he reported that he could not accomplish physical fitness testing, but could walk 2½ miles.  At the MEB examination on 27 December 2003, 4 months prior to separation, the CI reported right hip and right foot pain with tingling from the pelvis down.  The examination of the pelvis and spine was noted to be unremarkable with no tenderness.  Provocative testing for nerve root irritation was negative.  The MEB NARSUM recorded that the CI had low back pain for 3-4 years, but that his physical examination (based on the above MEB examination) was unremarkable.  The pain increased with activity and prolonged sitting, but painful motion was not clearly documented.  The CI reported that moving around relieved his pain when he had sat too long.

The VA Compensation and Pension (C&P) examination was not performed until 19 August 2005, 28 months after separation.  The CI reported that he had worked as a truck driver and commercial fisherman after separation, but had difficulty secondary to back pain.  He had a normal gait and neurological examination.  The back range of motion (ROM) was normal except for flexion which was 25 degrees (normal 30) with painful motion.  X-rays were unremarkable other than post-surgical changes of the pelvis.  Following separation, he had not been able to keep two different jobs due to the (not unfitting) back pain.  The examiner attributed the back pain to the motorcycle accident.

The Board directed its attention to its rating recommendation based on the above evidence.  The PEB rated the pelvic fracture condition at 0%, analogously coded 5099-5003 (degenerative arthritis), no justification cited.  The VA rated the pelvic fracture condition at 10%, coded 5010 (arthritis due to trauma) based on the C&P examination 28 months after separation, citing painful or limited motion of a major joint with X-ray evidence of degenerative changes.  The Board agreed that the evidence showed the CI had reasonable function after the surgery, but he was not able to meet full duty requirements.  After separation, he had not been able to keep two different jobs which was attributed to the (not unfitting and not contended) back pain.  The VA C&P examiner attributed the back pain to the motorcycle accident.  The Board considered the application of VASRD §4.59 (painful motion) but did not find evidence that motion was painful although his chronic pain clearly increased with activity.  The Board also considered VASRD §4.40 (functional loss), but noted that the CI could walk 2½ miles even though he could not run.  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 pain from pelvic fractures condition.

BOARD FINDINGS:  In the matter of the chronic pain from pelvic fractures 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 20140701, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB

MEMORANDUM FOR Commander

SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXXXXX, AR20160011590 (PD201403697)

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