RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01063
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20040420

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Multi-Channel Transmission Systems Operator/Maintainer, medically separated for “left hip pain,” with a disability rating of 0%.

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 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 - 20040102	VA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Hip Pain	5099-5003	0%	No VA Disability Claim Filed	
Panic Disorder	Not Unfitting		
Dysthymia.	Not Unfitting		
Post-Traumatic Stress Disorder	Not Unfitting		
Dysmenorrhea.	Not Unfitting		
Vision Defect	Not Unfitting		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:

Left Hip Pain.  According to service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left hip pain condition began in May 2001 after being hit in the hip by a wall locker she was moving.  The CI underwent stabilization surgery of the left femoral neck stress fracture 19 April 2002, 24 months prior to separation.  The condition could not adequately be rehabilitated to allow for unrestricted activity or completion of tasks appropriate to the CI’s MOS.  The MEB forwarded “persistent left hip pain” for PEB adjudication.

The MEB NARSUM examination on 2 December 2003, 5 months prior to separation, noted complaints of persistent left hip pain that was made worse with prolonged sitting, climbing in and out of military vehicles, strenuous weight bearing exercises, and awkward positions.  The CI could not run, jump, march with a rucksack, or train for a standard Army physical fitness test without aggravating her pain.  Physical examination showed left hip flexion to 112 degrees (normal 125), extension 20 (normal 20), abduction 35 (normal 45) and adduction 10 (normal 45), and all limited by pain.

The CI did not file a VA disability claim; and therefore, there was no VA Compensation and Pension evaluation for Board review.

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip pain condition 0%, analogously coded 5099-5003 (degenerative arthritis).  There was no VA rating.  The Board agreed the X-ray findings on 04 September 2003 did not show evidence of arthritis to support a rating using code 5003.  Board members agreed that there was insufficient limitation of range of motion to provide a minimum rating using VASRD codes 5251 (thigh, limitation of extension of), 5252 (thigh, limitation of flexion of) or 5253 (thigh, impairment of).  In addition, there was no indication of a flail joint of the hip to support an 80% rating using code 5254, ankylosing of the hip to support a 60% rating using code 5254 or malunion of a femur fracture to support a 10% or higher rating using code 5255.  The Board found sufficient evidence of painful motion (IAW VASRD §4.59) to support a minimum compensable rating of 10%.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10% for the left hip pain condition, analogously coded 5299-5252.

Contended PEB Conditions:  Panic Disorder; Dysthymia; Post-Traumatic Stress Disorder; Dysmenorrhea; and Vision Defect.  The Board’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  None of the conditions were profiled or implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the Board concluded that there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions and so no additional disability ratings are recommended.

BOARD FINDINGS:  In the matter of the left hip pain condition, the Board unanimously recommends a disability rating of 10%, analogously coded 5299-5252 IAW VASRD §4.71a.  In the matter of the contended panic disorder, dysthymia, post-traumatic stress disorder, dysmenorrhea and vision defect conditions, the Board unanimously recommends no change from the PEB determinations as not unfitting.  There were no other conditions within the Board’s scope of review for consideration.  

The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:

CONDITION	VASRD CODE	PERMANENT RATING	
Left Hip Pain	5299-5252	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150612, w/atchs
Exhibit B.  Service Treatment Record

AR20170011798, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	
Enclosure