RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00858
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070727

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

CI CONTENTION:  “Review 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 upon a 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 - 20070712	VARD - 20141119	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip Pain	5099-5003	10%	Inferior Pubic Stress Fracture and Trochanteric Bursitis, Right Hip	5019-5252	10%	20141107	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

Right Hip Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right hip condition began in October 2006 with no inciting injury.  Radiographs and bone scan showed right inferior pubic rami stress fractures, bilateral shin splints and right greater trochanteric bursitis.  The MEB forwarded “right inferior rami stress fracture” and “right greater trochanteric bursitis” for PEB adjudication.  The MEB NARSUM examination on 29 May 2007, 2 months prior to separation, noted complaints of hip pain 75-100% of the day.  She occasionally took anti-inflammatory medication and declined offers for narcotics.  There were no surgical indications at the time.  Physical examination showed she was walking with a cane.  There was moderate tenderness over the greater trochanter as well as the right inguinal region with minimal posterior hip discomfort.  Motor and sensory functions were intact.  She had an out-toeing greater than 15 degrees and could cross her legs without difficulty.  Range of motion (ROM) measured by goniometer and limited by pain demonstrated flexion to 113 degrees (normal 125 degrees), extension 15 degrees (normal 30 degrees), abduction 39 degrees (normal 45 degrees), adduction 38 degrees (normal 25 degrees), external rotation 32 degrees (normal 60 degrees) and internal rotation 28 degrees (normal 40 degrees.)  The VA Compensation and Pension (C&P) examination was completed over 7 years after separation and has no probative value for rating at the time of separation.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 10%, coded 5099-5003 (analogous to degenerative arthritis), citing application of the US Army Physical Disability Agency (USAPDA) pain policy.  Using the information in the treatment record, the Board determined that the CI’s right hip was essentially non-compensable based on the VASRD §4.71a codes for loss of hip/thigh motion (5250 through 5253).  There was no fracture, non-union, or mal union of the femur or tibia to support consideration under the respective codes for hip impairment related to long bone conditions (5255, 5262).  According to VASRD §4.59, a 10% rating is warranted when there is satisfactory evidence of functional limitation due to painful motion of a major joint.  Although the fracture had supposedly healed, the right hip pain was recurring and limiting.  The Board unanimously agreed that a rating of 10% was warranted for the right hip condition and there was no evidence to support a rating higher than 10%.  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 right hip pain condition.  

BOARD FINDINGS:  In the matter of the right hip pain condition and IAW VASRD §4.71a, the Board 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 20150604, 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

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20170000811 (PD201500858)

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