RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00944
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20020421

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Military Police, 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 - 20020111	VARD - 20020911	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain Secondary to Piriformis Syndrome	5318	10%	Right Hip, Piriformis Syndrome with Sciatica	5318-8520	0%	20020528	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Right Hip. According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s leg condition began in October 1999 during a physical fitness run.  She was initially thought to have a knee condition, but later determined to have a right pyriformis syndrome (pain from one of the hip muscles irritating the sciatic nerve).  X-rays of both hips were normal.  Despite medications, duty restrictions, and physical therapy, pain persisted and she could not meet the physical requirements of her military specialty.  The MEB forwarded “chronic right hip pain/piriformis syndrome” for PEB adjudication.

The MEB NARSUM examination on 27 November 2001, 5 months prior to separation, noted complaints of ongoing right hip pain.  Physical examination revealed the able to heel and toe walk and no muscle atrophy.  The range of motion (ROM) was flexion 70 (normal 125), extension (normal 20), external rotation 30 (normal 45), abduction 30 (normal 45), adduction 10 (normal 45), and no painful motion.

At the VA Compensation and Pension (C&P) evaluation performed on 28 May 2002, 1 month after separation, the CI reported ongoing right hip pain.  Physical examination showed normal posture and gait, no assistive device used, and lower extremities appeared symmetric.  The ROM was flexion 125, extension 30, external rotation 60, abduction 45, adduction 25, and no painful motion.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic right hip pain condition secondary to piriformis syndrome at 10%, coded 5318 (Group XVIII muscles which include the pyriformis), for moderated impairment.  The VA rated the right hip piriformis syndrome with sciatica at 0%, analogously coded 5318-8520 (Group XVIII muscles-sciatic nerve paralysis) based on the VA C&P examination 1 month after separation, citing a normal examination.

Board members agreed there is no compensable ROM limitation under the applicable codes; no ankylosis, fracture deformity, flail joint or instability, nonunion/malunion; and, no evidence of a muscle or nerve impairment to support a rating higher than the PEB’s 10% 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 right hip 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 20150604, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander

08 MAR 2017

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for 
XXXXXXXXXXXXXXXXXX, AR20170000869 (PD201500944)

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