RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01278
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050401

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Allied Trades Specialist, medically separated for “chronic right hip and groin pain,” with a disability rating of 0%.

CI CONTENTION:  She requests review of all conditions.  Her 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 - 20050317	VARD - 20050924	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip & Groin Pain	5099-5003	0%	Residuals…Stress Fracture	5010-5252	0%	20050910	
Mild Dorsal Scoliosis	Not Unfitting 	No VA Placement	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Right Hip and Groin Condition.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI injured her right hip and groin on the obstacle course in the 6th week of basic training.  A 23 September 2004, right hip X-ray was normal.  An 8 November 2004 pelvis X-ray showed a healing right inferior pubic ramus stress fracture (repetitive stress induced fracture).  The 16 November 2004 physical therapy (PT) examination documented a normal gait.  The right hip examination revealed no tenderness, crepitus (grating sensation or sound), edema (excess tissue fluid swelling), erythema (redness), ecchymosis (bruising), effusion (fluid collection), or deformity.  The range of motion (ROM) was full and without pain.  The thigh squeeze (assesses for groin or adductor strain), heel tap (assesses for fracture or joint pathology), scours (assesses for hip joint dysfunction), Patrick (assesses hip and sacroiliac joint pathology), and leg hop (assesses hip strength deficits) tests were negative.  A 20 November 2004 pelvis X-ray showed no acute fracture and a healed right inferior pubic ramus fracture.  The 29 November 2004 PT examination documented an antalgic (assuming a gait or posture to lessen pain) gait.  Right hip active ROM was normal with pain on flexion and internal rotation.  The Patrick test was positive and the heel tap, scours, log roll (assesses for hip joint pathology), and straight leg raise ([SLR] assesses for herniated disc causing sciatic nerve root [L5-S1] radiculopathy) tests were negative.  

In the 2 March 2005 NARSUM, 1 month before separation, the CI complained of right hip and groin pain that was 2-3/10 at rest, and 7/10 with physical activity.  The CI did not experience significant relief with activity modification, 30 days of unit convalescent leave, and PT.  Under physical examination the examiner documented “Please see the detailed physical examination and review of systems done by the undersigned on 21 Jan 05, DD 2807 and DD 2808.”  The focused physical examination documented a non-antalgic tandem gait.  The pelvis examination revealed right inferior pubic ramus and inguinal fold tenderness.  The hip examination revealed “normal full range of motion” with no lower extremity swelling or edema.  The SLR and heel tap tests were positive and the log roll and scours tests were negative.  Strength, sensation, pulses, and deep tendon reflexes (DTRs) were normal.  The examiner recounted the findings of the X-rays.  The diagnosis listed right inferior pubic ramus stress fracture and chronic pain.  In the 10 September 2005 VA Compensation and Pension (C&P) examination, 4 months before separation, the CI complained of mild intermittent right hip pain with remissions.  Symptoms were exacerbated by cold weather and activity and incompletely relieved with PT and Motrin.  The physical examination documented a normal gait.  The right hip examination revealed joint and pubic area tenderness with no evidence of inflammatory arthritis, swelling, effusion, laxity, or ankylosis (joint stiffening or immobility).  Right hip ROM was flexion of 125 (125 normal), extension of 30 (30), abduction of 40 (45), and external rotation of 60 (60) degrees.  There was no loss of motion on repetitive use.  Strength, sensation, and DTRs were normal and pathologic reflexes were absent.  The examiner could not perform X-rays due to pregnancy.  The diagnosis listed inferior pubic ramus stress fracture residuals.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 0% rating under an analogous 5003 code (arthritis, degenerative) citing chronic right hip and groin pain, right inferior pubic ramus stress fracture by X-rays, normal ROM and strength, and tenderness over fracture site.  The VA assigned a 0% rating under the 5010-5252 codes (arthritis, due to trauma-thigh, limitation of flexion of) based on the C&P examination 4 months before separation, citing chronic right hip and groin pain, right inferior pubic ramus stress fracture by X-rays, normal ROM, and no loss of motion on repetitive use.  There was no compensable thigh limitation of extension (5251), thigh limitation of flexion (5252), or thigh impairment of abduction, adduction, or rotation (5253) for consideration under the respective codes.  There was no hip ankylosis (5250), hip flail joint (5254), or femur fracture nonunion/malunion (5255) for consideration under the respective codes.  Panel members agreed a 10% rating was not justified IAW §4.40 (functional loss) and §4.59 (painful motion).  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 right hip and groin condition.  

Contended PEB Condition:  Mild Dorsal Scoliosis.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was not profiled, implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that the condition 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 the contended condition and so no additional disability rating is recommended.  
BOARD FINDINGS:  In the matter of the right hip and groin condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended mild dorsal scoliosis, the panel unanimously agrees that it cannot recommend it for additional disability rating.  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 20150614, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170007461, XXXXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

	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,					      
						      					
Enclosure