RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00715
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060305

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Information Systems Operations Analyst, medically separated for “chronic right hip pain” with a disability rating of 10%.  

CI CONTENTION:  Her condition continues to negatively impact her activities.  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 20060113	VARD - 20060814	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain	5099-5003	10%	Right Hip Strain	5252	10%	20060111	
RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Right Hip Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right hip condition began in February 2005 with no prior trauma.  Radiographic evaluation (X-ray and bone scan) in February 2005 showed no evidence of traumatic, arthritic, or inflammatory changes.  Further imaging (MRI) in October 2005 showed no evidence of edema or effusion.  There was no surgical indication, and conservative treatment did not result in improvement sufficient to allow unrestricted duty.  

At the 6 December 2005 MEB examination (recorded on DD Form 2808), 3 months prior to separation, the physical examination showed “decreased” range of motion (ROM).  The 6 December 2005 MEB NARSUM examination noted complaints of pain occurring most of the day, and aggravated by prolonged standing and sitting.  The physical examination showed range of motion (ROM) in degrees of flexion of 70 (normal 125), extension 15 (normal 20), adduction 15 (normal 45), abduction 25 (normal 45) and evidence of painful motion.  

At the 11 January 2006 VA Compensation and Pension (C&P) evaluation, 10 months after separation, the CI reported constant pain that limited prolonged walking, running and standing.  She denied incapacitation and time lost from work.  The physical examination showed normal flexion, extension, adduction, and abduction.  There was evidence of painful motion with no further decrements after repetition.  

The panel directed attention to the rating recommendation based on the above evidence.  The PEB rated 10% for the right hip condition, analogously coded 5099-5003 (degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA also rated the right hip condition 10%, coded 5252 (thigh, limitation of flexion), based on the C&P examination 10 months after separation, citing painful motion.  

The panel considered the evidence for a higher rating.  There was no evidence of ankylosis (5250), or flexion limited to 30 degrees (5252) in support of a higher rating.  There was no evidence of limitations in abduction (motion lost beyond 10 degrees), or adduction (inability to cross legs), in support of a higher rating under 5253.  There was documentation of limited rotation (cannot toe out more than 15 degrees) in support of 10% rating under 5253.  Application of VASRD §4.59 (painful motion), §4.40 (functional loss), §4.45 (the joints) was supported by documentation (painful motion and mechanical limitations of the hip) for a 10% rating coded as 5099-5003.  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 hip condition.  

BOARD FINDINGS:  In the matter of the right hip 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 20150601, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170006560, 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