RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00262
BRANCH OF SERVICE:  Navy 	SEPARATION DATE:  20050722

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3, Infantry, Gun Crew and Seamanship Specialist, medically separated for “right hip stress fracture,” with a disability rating of 10%.  

CI CONTENTION:  The CI makes no contentions.  The 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 - 20050712	VARD - 20050930	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Stress Fracture	5003-5255	10%	Right Hip Stress Fracture	5253	NSC	20050720	
RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Right Hip Stress Fracture.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI first presented with right hip pain on 28 September 2004 when she reported a 2-week history of pain following boot camp.  Localized tenderness was present, but her gait was normal.  She was seen on follow-up on 5 October 2004 and reported that the pain had resolved.  However, on 26 October 2004, she presented to the ship board clinic with recurrent right hip pain for 6 weeks, first noted during “battle stations” in boot camp.  Her examination was unremarkable other than painful motion.  She was referred to physical therapy (PT) and a trial of crutches was begun.  A bone scan was consistent with a stress fracture the clinical records (the report is not in evidence).  On 9 March 2005, she reported ongoing pain although her examination was now normal.  The MEB forwarded “pain in joint pelvic region and thigh” for PEB adjudication.  
At the MEB examination (recorded on DD Form 2807 and 2808) dated 17 June 2005, 1 month prior to separation, the CI reported recurrent hip pain.  On examination, she had minimal discomfort with motion of the right hip but an otherwise unremarkable evaluation.  The MEB NARSUM was dated 23 June 2005.  It noted that the first bone scan in December 2004 showed evidence of a healing stress fracture.  X-rays on 20 May 2005 were normal (previously a callous consistent with a healing stress fracture had been present) and a repeat bone scan on 27 May 2005 showed resolution of the prior activity (which indicated the healing stress fracture).  On examination, the range of motion (ROM) was full but painful at extreme internal rotation.  The examiner noted that she looked comfortable in the clinic even though she described 8/10 pain and had no objective findings on the examination or bone scan to account for her perceived pain.  At the VA Compensation and Pension (C&P) examination dated 20 July 2005, performed 2 days prior to separation, the CI reported constant right hip pain which was aggravated by activity.  The physical examination and hip X-rays were normal.  The gait was normal and no assistive device was used.  The examiner noted that the complaints of the CI did not match the physical findings to such a degree that a mental health evaluation was warranted.  No diagnosis was made (since the evaluation was normal).  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the CI at 10%, coded 5003-5255 (degenerative arthritis and impairment of the femur).  The VA did not service-connect the condition as it was resolved.  The evidence shows that the condition was objectively healed at separation.  The Board found no route to a rating higher than the 10% adjudicated by the PEB.  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) femoral neck stress fracture condition.  

BOARD FINDINGS:  In the matter of the right femoral neck stress fracture 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 20150412, 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 14 Nov 16

      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 USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN

						  XXXXXXXXXXXXXXXXXXXXX
	     				  Assistant General Counsel
						  (Manpower & Reserve Affairs)