RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01204
BRANCH OF SERVICE:  Marine Corps 	SEPARATION DATE:  20020823

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Intelligence Specialist, medically separated for “status post right inferior pubic ramus stress fracture,” with a disability rating of 10%.

CI CONTENTION:  The CI contends her ramus stress fracture.  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 - 20020611	VARD – 20031223	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Status Post Right Inferior Pubic Ramus Stress Fracture	5299-5003	10%	Residuals, Right Superior and Inferior Pubic Ramus Stress Fractures	5294-5252	0%	20031010	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Status Post Right Inferior Pubic Ramus Stress Fracture.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right hip condition began in August 2000 after extensive running.  Despite treatment, the 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 “right inferior pubic ramus stress fracture” for PEB adjudication.  The MEB NARSUM examination on 10 April 2006, 4 months prior to separation, noted complaints of right anterior pelvis pain with running, straight leg raising and climbing stairs.  Physical examination showed no pain with compression or distraction of the pelvis, and she had a negative flexion, abduction, and external rotation test.  Hip range of motion was normal.  She was neurovascularly intact and walked with a normal gait.  Radiographs showed evidence of a right inferior pubic ramus nonunion and was confirmed by a bone scan in October of 2000.  At the 10 October 2003 VA Compensation and Pension (C&P) evaluation, performed 14 months after separation, the CI denied any difficulty with gait or ambulation.  Physical examination showed she had no difficulty ambulating or gait abnormality.  At the 4 November 2003 VA C&P evaluation of the CI’s spine, performed 14 months after separation, the CI reported inguinal discomfort with prolonged standing and working.  Physical examination showed tenderness of the superior pubic rami.  Active range of motion of the right hip flexion from 118 degrees (normal 125), extension 30 degrees (normal 20), and abduction 45 degrees (normal 45).  There was complaint of hip discomfort on full internal rotation.  Strength of the right hip was in the range of normal.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition 10%, analogously coded 5003 (arthritis, degenerative).  The VA rated the right pubic ramus condition 0% coded 5294-5252 (pelvic fracture-thigh, limitation of flexion), based on the VA C&P examination 14 months after separation, citing a non-compensable evaluation.  The right hip and thigh had no limitation of flexion or extension that supported a rating under the VASRD diagnostic codes for limitation of motion (5251, 5252, or 5253).  There was also no evidence of the hip being a flail joint under code 5254.  However, the Board concluded that there was sufficient evidence of painful motion and functional loss to support a 10% rating for the right pubic ramus IAW §4.59, §4.40 and §4.45.  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 condition.  

BOARD FINDINGS:  In the matter of the status post right inferior pubic ramus stress fracture 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 20150611, w/attachments
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 7 Dec 16

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC