RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00385
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20040309

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Trainee, medically separated for “right inferior pubic ramus fracture,” with a disability rating of 0%.

CI CONTENTION:  The CI complains of abdominal pain and scar tissue.  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 - 20040115	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Inferior Pubic Ramus Fracture	5099-5003	0%	No VA Examination in Evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Right Pubic Ramus Fracture.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI presented for a pelvic X-ray on 16 September 2003, noting a history of pain for 3 weeks, beginning of the 3rd week of basic training.  The X-ray showed a healing stress fracture of the right pubic ramus (the right pubic bone).  She was treated with duty limitations and physical therapy (PT).  A PT evaluation on 26 September 2003 recorded a painful gait and painful flexion of the hip past 120 degrees.  The next record was dated 29 October 2003 and also a PT evaluation.  At this visit and all subsequent clinical visits, the CI had a normal gait, full active range of motion (ROM) and was able to squat.  She was also treated with convalescent leave and then administrative duties with a reduction in her symptoms.  However, she was not able to return to full activities and was entered into the MEB process.  The MEB NARSUM examination performed on 12 December 2003, 3 months prior to separation, noted that the CI was not able to run and had increased pain if she attempted to walk over 1 mile.  On examination, the ROM was normal (for the values recorded) and gait was normal.  Motion was pain free.  A heel tap did provoke minimal discomfort.  It was noted that interval X-rays (not in evidence) had showed healing.  It was noted that she would not be able to complete training and a PEB was recommended.  There was not a VA Compensation and Pension (C&P) evaluation in evidence.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right inferior pubic ramus fracture condition 0%, coded 5099-5003 (analogous to degenerative arthritis.  The record shows that the fracture was healed on X-ray as documented on the NARSUM.  The examination was essentially normal other than minimal discomfort from a heel tap.  She was separated as she was not able to complete training.  No specific code is present for a stress fracture of the pubic ramus.  The evidence shows that it was essentially healed at separation.  The Board found no route to a higher rating.  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 inferior pubic ramus fracture condition.  

BOARD FINDINGS:  In the matter of the right inferior pubic ramus fracture 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 20150601, 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

19 DEC 2016

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20160018711 (PD201500385)

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