RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00409
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20060623

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Heavy Construction Equipment Operator, medically separated for “left hip pain,” with a disability rating of 10%.

CI CONTENTION:  Consider hip condition.  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 - 20060511	VARD - 20071001	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Hip Pain	5099-5003	10%	Left Hip Bursitis	5019	10%	20070303	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:

Left Hip Pain.  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left hip pain condition began in January 2003 following a parachute jump.  Radiographic imaging (X-rays, MRI, and bone scan) was normal.  Despite treatment with duty limitations, medications, and physical therapy, the CI was not able to return to full duty status.  The MEB forwarded “left hip pain” to the PEB for adjudication.

The MEB NARSUM examination (recorded on DD Forms 2807 and 2808) dated 17 October 2005, 8 months prior to separation, note complaints of chronic left hip pain aggravated by running.  Physical examination revealed full- and pain-free range of motion (ROM).  Tenderness was absent.  An orthopedic MEB NARSUM Addendum was prepared on 21 March 2003 (3 months prior to separation), reported the CI’s symptoms were unchanged with full ROM.  Voluntary snapping of the left iliotibial band (a band of connective tissue running on the outside of the thigh) was demonstrated over the left hip, which was determined to be the cause of his hip pain.  The examiner opined that the hip was stable.

The 3 March 2007 VA Compensation and Pension (C&P) examination, 8 months after separation, noted hip symptoms had improved since separation, but were aggravated by increased activity.  Posture and gait were normal.  No assistive device were used.  There was left hip (greater trochanteric) bursa (a gel filled sac to reduce friction) tenderness.  ROM was normal other than a reduction in internal rotation.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing the U.S. Army Physical Disability Agency pain policy.  The VA also rated the left hip condition 10%, coded 5019 (bursitis) based on the VA C&P examination 8 months after separation, citing painful motion.  The Board considered the evidence and found no route to a higher rating with applicable hip codes.  There was no compensable loss of motion, thigh impairment, or femoral impairment to support 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 left hip pain condition.

BOARD FINDINGS:  In the matter of the left 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 20150531, 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

07 Feb 2017

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20160019841 (PD201500409)

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