RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01347
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20030207

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Construction Equipment Repairer, medically separated for “chronic pain, right hip,” with a disability rating of 10%.  

CI CONTENTION:  The CI made no specific contention.  His 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 - 20021119	VARD - 20040310	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain, Right Hip, Status Post [Surgery]	5099- 5003	10%	Residuals, Status Post [Surgery], Right Hip	5252	10%	20040117	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Chronic Pain, Right Hip, Status Post [Surgery].  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s hip condition began during a prior enlistment and resulted in surgery for removal of a chronically inflamed trochanteric bursae in December 2000.  After reenlistment, the hip was reinjured in March 2002 during physical training.  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.  

At an August 2002 sports medicine visit, 6 months prior to separation, the physical examination showed tenderness over the greater trochanter, flexion to 30 degrees (normal 125), and markedly decreased external and internal rotation, limited by pain.  During the 13 September 2002 MEB examination (recorded on DD Forms 2807 and 2808), 5 months prior to separation, the physical examination showed “full” extension and flexion of the hip with “normal” external and internal rotation.  Pain was not addressed.  The 18 October 2002 MEB NARSUM examination, 4 months prior to separation, noted complaints of continued pain along the surgical scar and lateral hip (at the greater trochanter).  The physical examination showed “marked” tenderness over the greater trochanter, and “full” internal and external rotation with “markedly increased” pain.  Flexion and extension were “normal.”  Radiographs were reportedly normal.  

At the 17 January 2004 VA Compensation and Pension (C&P) evaluation, performed 11 months after separation, the CI reported stiffness that was worse in the morning and after being on his feet too long, and had problems with bending and squatting.  The physical examination showed an antalgic gait without use of assistive devices.  Flexion was to 100 degrees, and extension was to 15 degrees (normal 20).  Abduction and adduction were each to 20 degrees, and external rotation was to 40 degrees (all normal at 45).  There was pain with range of motion (ROM).  The CI refused to squat, however, he could rise up on the toes, and tandem walk.  Radiographs were reportedly normal.  

The panel directed attention to the rating recommendation based on the above evidence.  The PEB rated 10% for the right hip condition, analogously coded 5099-5003 (arthritis, degenerative), citing “slight/constant” pain IAW the U.S. Army Physical Disability Agency Policy for rating pain.  The VA also rated 10% for the right hip condition, coded 5252 (thigh, limitation of flexion), based on the VA C&P examination 11 months after separation, citing limitation of flexion.  Application of VASRD §4.59 (painful motion), §4.40 (functional loss), §4.45 (the joints) was supported by documentation (painful motion and mechanical limitations of the hip) for a 10% rating as adjudicated by the PEB.  There was no evidence of ankylosis and no evidence of limitations in abduction (motion lost beyond 10 degrees) to support higher ratings under codes 5250 or 5253, respectively.  There was 1 entry that documented flexion limited to 30 degrees (August 2002), however, the more proximate MEB 2808, NARSUM, and VA C&P examinations documented normal or near full ROM, and therefore a higher rating was not supported.  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 condition.  

BOARD FINDINGS:  In the matter of the right hip condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There were no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150613, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170007468, 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,					       
						      					
Enclosure