RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00772
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20030930

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Basic Marine, medically separated for “stress fracture right superior pubic rami [SPR]” with a disability rating of 10%.  

CI CONTENTION:  His back and pelvis issues have worsened, he was recently hospitalized, and he has other medical 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.  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 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 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 - 20030814	VARD - 20040319	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Stress Fracture Right SPR	5022-5003	10%	Residuals, Stress Fracture of Right SPR and IPR	5251	0%	20040106	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Right Pelvic Stress Fracture.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI was evaluated for a pneumonia on 20 May 2003 and also found on X-ray to have a stress fracture of the superior and inferior pubic rami (SPR and IPR) on the right.  He was subsequently admitted for intravenous antibiotics and given non-weight bearing on crutches.  During the hospital course, the pneumonia resolved and he was able to ambulate with crutches including stairs.  He was placed on medical hold following discharge from the hospital and entered into the MEB process as it was not anticipated that he could return to basic training in a timely fashion.  In addition, the CI no longer wished to remain in the service.  The final orthopedic note in the record was dated 16 July 2003.  It noted a normal examination other than slight deconditioning.  

During the 6 January 2004 VA Compensation and Pension (C&P) evaluation, 3 months after separation, the CI reported that he had not exerted himself since he was hospitalized (in May 2003) and had intermittent right buttock and groin pain after prolonged sitting.  He reported no activity limitations and stated that he could push a lawn mower.  The gait was not recorded, but the examination was otherwise noted to be normal including a pelvic X-ray.  A 21 June 2004 neurological C&P, 9 months after separation, documented a normal examination including gait and posture.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right SPR stress fracture condition 10%, coded 5022-5003 (degenerative arthritis).  An IPR stress fracture was a related condition.  The panel noted that the impairment from each would overlap and cannot be separated for rating purposes.  As discussed below, this had no impact on the rating recommendation.  

The VA rated the right SPR and IPR stress fracture condition 0%, coded 5251 (limitation of extension of the thigh), based on the C&P examination 3 months after separation, essentially citing a normal examination.  The evidence shows that the stress fractures were clinically resolved prior to separation and also resolved on a post-separation X-ray.  No residual impairment was in evidence at the time of or following separation which supports a 0% rating.  The panel does not recommend a rating less than that adjudicated by the PEB.  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 pelvic stress fracture condition.  

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

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150603, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 26 Apr 17

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXXXXX, former USN 
		- XXXXXXXXXXXXXXXXXXXXX, former USMC 
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXXX, former USMC

						  XXXXXXXXXXXXXXXXXXXXX
	     				  	Assistant General Counsel
						                				(Manpower & Reserve Affairs)