RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXX		CASE: PD-2015-01181 BRANCH OF SERVICE: ARMY	SEPARATION DATE: 20080202

SUMMARY OF CASE: Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Petroleum Supply Specialist, medically separated for “bilateral hip bursitis” with a disability rating of 20%.

CI CONTENTION: The CI requests the panel review all 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 or non-compensable. 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 determination 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(s) 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 - 20090223		VARD - 20080424	
Condition	Code	Rating		Condition	Code	Rating	Exam	
Bilateral Hip Bursitis	5019	20%		Right Hip Bursitis	5019	10%	20080331	
				Left Hip Bursitis	5019	10%	20080331	
Cervical Dysplasia	Not Unfitting		No VA Placement	
Pelvic Pain	Not Unfitting		No VA Placement	
COMBINED RATING: 10%		COMBINED RATING OF ALL VA CONDITIONS: 20%	

ANALYSIS SUMMARY:

Bilateral [Hip] Bursitis. According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s hip condition began in March 2006 without trauma or injury. X-rays and magnetic resonance imaging (MRI) of the bilateral hips in April 2006 and March 2007 respectively, were normal. There was no surgical indication, and conservative treatment did not result in improvement sufficient to allow unrestricted duty.

At the MEB examination (recorded on DD Forms 2807 and 2808) dated 14 May 2007, 9 months prior to separation, the CI reported sitting or standing too long caused her hips and legs to go numb and tingle. She was unable to stand, sit or lie down for prolonged periods due to hip pain. The CI noted that she was not taking any medication for her condition. Physical examination documented “decreased” range of motion (ROM) bilateral hips.

At the MEB NARSUM examination on 18 September 2007, 5 months prior to separation, the CI reported as time passed, her pain became more intense and less responsive to medications. She noted that she was unable to perform high impact exercises such as running, jumping, climbing, lifting, squatting and walking over rough or uneven ground. Physical examination recorded normal gait, normal ambulation and body motion, no neurologic deficits and normal muscle strength. There was tenderness to palpation over the greater trochanter of both hips, and passive ROM of both hips was normal. The examiner referenced the goniometric ROM performed on 30 August 2007. Physical therapy ROM dated 30 August 2007, approximately 5 months prior to separation, recorded 110 degrees of flexion (125 normal) in the right hip, and 108 degrees in the left hip.

At the 31 March 2008 VA Compensation and Pension (C&P) evaluation, performed 2 months after separation, the CI reported pain, weakness and stiffness in her hips. She stated that she had locking and giving way of her legs. She had not use assistive device and had no treatment, and her condition had not impacted daily activities or her work. Physical examination showed “smooth and even” gait, no impairment in ambulation, and good muscle strength. She was able to perform a full squat. ROM recorded 125 degrees of flexion (normal) in both hips, with painful motion in all planes bilateral hips.

The panel directed attention to its rating recommendation based on the above evidence. The PEB administratively corrected the initial 10% rating bilateral hip to reflect a rating of 10% each hip, coded 5019 (bursitis), for “minor functional loss caused by pain from repeated use of flare- ups” for a combined disability rating of 20%. Likewise, the VA assigned 10% rating to each hip under the same code (5019), based on the VA C&P examination 2 months after separation, citing “painful or limited motion.”

Panel members agreed, the PEB’s adjudication of 10% each hip based on painful motion was supported, and there was no justification for a rating higher than the combined 20%. 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 bilateral hip condition.

Contended PEB Conditions: Cervical Dysplasia and Pelvic Pain. The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting. Neither 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 either of the conditions significantly interfered with satisfactory duty performance at separation. After due deliberation, the panel concluded that there was insufficient cause to recommend a change in the PEB fitness determination for either of the contended conditions and so no additional disability ratings are recommended.

BOARD FINDINGS: In the matter of the bilateral hip condition and IAW VASRD §4.71a, the panel recommends no change in the PEB adjudication. In the matter of the contended cervical dysplasia and pelvic pain conditions, the panel recommends no change from the PEB determinations as not unfitting.  There were no other conditions within the panel’s scope of

review for consideration. The panel, 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 20150605, with attachments Exhibit B. Service Treatment Record
Exhibit C. Department of Veterans Affairs Treatment Record

AR20170012854 , XXXXXXXXXXXXXXXXXX

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Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	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.

Sincerely,