RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00498
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20081014

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an National Guard E3, Basic Trainee, medically separated for “bilateral femoral neck stress fractures,” rated 10% for each hip respectively, with a combined rating of 20%.

CI CONTENTION:  The CI requests the Board consider all conditions.  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:  

IPEB - Dated 20080923	VARD -  Not Authorized for release by the CI	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Femoral Neck Stress Fractures	5299-5255	20%					
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS: 	

ANALYSIS SUMMARY:  

Bilateral Femoral Neck Stress Fractures.  According to service treatment record and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s bilateral hip condition insidiously began in early 2008 during basic training without apparent trauma.  Radiographic imaging studies of both hips revealed stress fractures.  Conservative treatment for her painful hip condition did not result in improvement sufficient to allow unrestricted duty.  The MEB forwarded “bilateral femoral neck stress fractures involving the compressive side” for PEB adjudication.  
At the MEB NARSUM physical examination (PE) performed on 15 August 2008, 2 months prior to separation, the CI’s chief complaint was “bilateral hip pain.”  Her PE revealed bilateral hip tenderness.  Her hip range of motion (ROM) was bilaterally painful and mildly decreased in all directions.  There was no evidence of lower extremity muscular atrophy or abnormal neuro-sensory/strength measurements.  

The CI did not give consent for the Board review of VA treatment records.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB separately rated each hip at 10% under VASRD analogous code 5255 (Femur impairment); indicating “slight” disability.  Board members agreed that the PEB’s chosen primary code of 5255 was appropriate in this case and that the clinical evidence of painful motion (VASRD §4.59) coupled with local hip tenderness supported no greater than the PEB’s unilateral “slight” impairment rating.  Therefore, 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’s combined 20% adjudication for the bilateral hip condition.

BOARD FINDINGS:  In the matter of the bilateral hip 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 modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150601, with attachments
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 
XXXXXXXXXXXXXXXXXX, AR20160018727 (PD201500498)

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