RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00603
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090416

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Basic Trainee, medically separated for “right femur stress fracture…” with a combined (if applicable) disability rating of 10%.

CI CONTENTION:  “Review of all conditions.”  The complete submission is at Exhibit A.

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(s) at the time of separation.  The panel 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 panel 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 - 20090401	VARD – None	
Condition	Code	Rating	Code	Code	Rating	Exam	
Right Femur Stress Fracture	5299-5255	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Right Femur Stress Fracture.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right femur condition began in September 2008 after running. The fracture was confirmed by bone scan on 12 November 2008.
The 2 February 2009 MEB NARSUM examination, 2 months prior to separation, noted complaints of right hip pain with prolonged walking, standing, and running which periodically woke him up at night.  Physical examination showed right lower extremity muscle strength was normal.  There was a slight decrease (measurements not given) in active right hip range of motion (ROM) for flexion, extension, and abduction with painful motion.

At a primary care evaluation dated 17 March 2009, 1 month prior to separation, the CI reported persistent right hip pain with standing, running, and other activities.  The physical examination showed right upper leg tenderness and painful hip ROM (measurements not given) at extremes.

There was no VA Compensation and Pension examination performed for this panel to review.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right femur condition 10%, analogously coded 5255 (femur, impairment), citing slight knee or hip disability.  

The panel agreed there was no limitation of motion which supported a rating under the diagnostic codes for limitation of motion (5251, 5252, and 5253).  However, there was evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45) as adjudicated by the PEB.  There was no evidence of moderate hip disability to support a 20% rating analogous to 5255.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the right femur stress fracture condition.

BOARD FINDINGS:  In the matter of the right femur stress fracture condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, 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 20150604, w/atchs
Exhibit B.  Service Treatment Record

AR20170006530, XXXXXXXXXXXXXXXXXX 

Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,					       
						      					
Enclosure