RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-04342
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20061206

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Signal Support Systems Specialist, medically separated for “chronic right hip pain,” with a disability rating of 0%.  

CI CONTENTION:  The CI contends her hip rating should increase.  Additionally, the CI contended her back condition which was not identified by the MEB or PEB.  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 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 – 20060816	VARD - 20070209	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain	5099-5003	0%	Chronic Right Hip Pain	5252	NSC	20061028	
			Chronic Right Leg Pain Secondary to Hip	5299-5262	NSC		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Chronic Right Hip Pain.  According to service treatment record and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right hip pain condition began in July 2004 after a fall during a ruck march.  The MEB forwarded chronic right greater trochanteric bursitis for PEB adjudication.  The MEB NARSUM examination on 17 May 2006, 7 months prior to separation, the CI noted complaints of frequent intermittent pain from the central lower pelvic region radiating to the right lateral hip that is sharp, burning, and stabbing in nature.  The pain is aggravated by running, sit-ups, rucksack marching, wearing of a rucksack or body armor, going up or down stairs, riding in a tactical vehicle, climbing upon or down from tactical vehicles, sitting for greater than 5 minutes or standing for greater than 10 minutes without a chance to move or stretch, flutter kicks, and repetitive bending, lifting, jumping or impact activities.  Physical examination showed range of motion (ROM) that was limited by soft tissue and was equal with the unaffected left hip and though she had crutches, she walked without a limp.  At the 28 October 2006 VA Compensation and Pension (C&P) evaluation, performed 1 month before separation, the CI reported constant right hip pain that traveled to the back of the right foot.  The pain was made worse by physical activity and relieved by rest and medication.  She denied the pain being incapacitating.  She also denied any functional impairment.  Physical examination showed limited adduction of the hip (moving toward and across the midline – 25 degrees instead of 30) otherwise full ROM and an otherwise normal hip evaluation.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip pain condition 0%, analogously coded 5099-5003 (arthritis, degenerative), citing full ROM, stability and minimal pain.  The VA also rated the right hip pain condition 0%, coded 5252 (thigh, limitation of flexion of), based on the VA C&P examination, citing full ROM and no pain with motion.  The CI complained of more than 2 years of hip pain after an injury in basic training.  She had a full work-up including multiple physical examinations, X-rays, bone scan, MRI, and neurodiagnostic studies, all of which were normal.  Using VASRD code 5003 requires two or more joints be involved to be rated greater than 0% and using code 5252 requires limitation of flexion of the thigh be 45 degrees or less to be rated at higher than 0%.  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 right hip pain condition.  

BOARD FINDINGS:  In the matter of the right hip 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 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

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
AR20160018408 (PD201404342)

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