RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00222
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20031114

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Military Police, medically separated for “right hip pain secondary to degenerative changes,” with a disability rating of 0%.  

CI CONTENTION:  “Review all records.”  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 - 20030325	VARD - 20030521	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Pain	5003	0%	Coxarthrosis Stage III Right Hip	5250-5010	10%	20030411	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Hip Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s hip condition began in June 2001 after he stepped out of a vehicle.  Initial radiographic imaging (MRI) in January 2002 documented a questionable right anterior labral tear with no evidence of bony lesion or degenerative changes.  A repeat MRI in October 2002 documented osteophytes (degenerative changes) of the femoral head and no evidence of a labral tear.  There was no surgical indication and conservative treatment did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “right hip pain secondary to early degenerative changes” for PEB adjudication.  

At the MEB NARSUM examination on 15 November 2002, 12 months prior to separation, the CI reported continuous pain, worsened with lifting, bending, stooping, or standing for prolonged periods of time.  The physical examination showed tenderness, flexion to 90 degrees (normal 125) with pain, extension to 10 degrees (normal 20) and normal external rotation.  

At the 11 April 2003 VA Compensation and Pension (C&P) evaluation 7 months prior to separation, the CI reported use of a cane, and pain worsened by prolonged sitting and standing, driving greater than an hour, and twisting the leg.  He was able to ride a stationary bike 5 days a week.  The physical examination showed a normal gait and ambulation with some slight support of a cane.  In the non-weight bearing position, there was full range of motion (ROM) without pain.  In the standing position, there was also full ROM, however, flexion and abduction elicited pain.  
	
The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 0%, coded 5003 (degenerative arthritis), citing “only 1 joint involved,” with some limitations of ROM secondary to pain.  The VA rated the right hip condition 10%, coded 5010 (arthritis, due to trauma), based on the VA C&P examination 7 months prior to separation, citing objective evidence of painful motion.  

Members agreed that there was sufficient evidence of painful motion and limited ROM to support a 10% rating, analogously coded 5299-5003 (degenerative arthritis) or 5299-5252 (thigh, limitation of flexion).  There was no documentation of hip ankylosis, limitation of abduction beyond 10 degrees, inability to cross the legs (adduction), limitation of rotation, or abnormal extension in support of alternate coding resulting in a rating higher than 10%.  There was no evidence of fracture or malunion of the femur.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the right hip condition analogously coded 5299-5252.  

BOARD FINDINGS:  In the matter of the right hip degenerative arthritis condition, the Board unanimously recommends a disability rating of 10%, coded 5299-5252.  IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  

The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Right Hip Degenerative Arthritis	5299-5252	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150317, 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

03 MAR 2017

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20170002569 (PD201500222)

1.  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, accept the Board’s recommendation to modify the individual’s disability rating to 10% without re-characterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

 BY ORDER OF THE SECRETARY OF THE ARMY:

CF: 
(  ) DoD PDBR
(  ) DVA