RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00893
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20071213

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Firefighter, medically separated for “chronic right hip pain,” with a disability rating of 10%.  

CI CONTENTION:  The CI requested the Board 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 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:  

SERVICE PEB - 20070924	VARD – 20140826	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain	5099-5003	10%	Right Hip Condition	5251	NSC	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Chronic 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 July 2006 after falling while on an obstacle course.  Diagnostic imaging showed an early effusion and then suggestion of stress reaction in the femoral neck and proximal femur.  Despite treatment, the right hip condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for an MEB.  The MEB forwarded “chronic right hip pain” for PEB adjudication.  

The MEB NARSUM examination on 23 August 2007, 4 months prior to separation, noted complaints of constant right hip pain and popping made worse with prolonged sitting or standing, or climbing, bending and squatting.  Physical examination showed normal motor strength with pain on right hip motion (SLR and FABER).  Physical therapy evaluation showed a normal gait with pain-limited right hip.  Range of motion (ROM) was measured as  110 degrees flexion (normal 125), 15 degrees extension (normal 20), external rotation 30 degrees (normal 45), abduction 30 degrees (normal 45), and adduction 20 degrees (normal 45).  The diagnosis was “chronic right hip pain due to stress reaction of femoral neck and proximal femur.”  

There was no VA Compensation and Pension (C&P) evaluation performed proximate to 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 limitations of hip motion due to pain with application of the US Army Physical Disability Agency pain policy.  The VARD dated 26 August 2014 (original claim - using the STRs and VA examinations in 2014) did not service connect the right hip; NSC (not service-connected) coded 5251 (thigh, limitation of extension), citing no permanent residual, or chronic disability.  All examination in evidence documented sufficient 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 limitation of motion which supported a rating under the diagnostic codes for limitation of flexion, extension, or thigh impairment for greater than a 10% rating (codes 5251, 5252, or 5253).  The Board next considered analogous rating analogous to code 5255 (femur, impairment of) and adjudged that the CI’s impairment at separation did not more nearly approximate the “moderate” knee or hip disability level to warrant the next higher (20%) rating.  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 chronic right hip pain 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 re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150609, 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, AR20170000828 (PD201500893)

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