RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01368
BRANCH OF SERVICE:  marine corps 	SEPARATION DATE:  20080331

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Basic Marine, medically separated for “left femoral neck stress fracture” with a disability rating of 10%.

CI CONTENTION:  “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 - 20080215	VARD - 20080912	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Femoral Neck Stress Fracture	5255	10%	Left Femoral Neck Stress Fracture	5255	0%	20080331	
Enuresis	Category IV	No VA Entry		
Adjustment Disorder with Depressed Mood	Category IV			
				
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Left Femoral Neck Stress Fracture.   According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left hip condition began in December 2007 after running.  During the 10 January 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), the examiner annotated a magnetic resonance imaging of the left hip showed a femoral neck stress fracture.  

The 23 January 2008 MEB NARSUM examination, 2 months prior to separation, noted complaints of persistent left femoral neck stress fracture pain.  The CI reported that he had “left hip pain for approximately 2-3 weeks that has since resolved.”  Physical examination showed normal coordination and balance.  The hip flexion was 120 degrees (normal 125) bilaterally.  There was not any discomfort with motion, tenderness to palpation or loss of thigh muscle strength.  There was not any loss of sensation to light touch in the hip or thigh areas.  The examiner cited a bone scan of the pelvis performed on 3 January 2008, which supported the diagnosis of stress fractures in the inferior left femoral head.  There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left femoral neck stress fracture condition 10%, coded 5255, (femur, impairment of). The VA rated the left hip condition 0%, coded 5255, (femur, impairment of) citing no evidence of malunion.  The evidence did not support a rating for thigh limitation of flexion (5252), extension (5251), or thigh impairment of rotation, adduction or abduction (5253).  There was no evidence of femur malunion resulting in moderate hip disability for a 20% rating.  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 left femoral neck stress fracture condition.  

Contended PEB Conditions: Adjustment Disorder with Depressed Mood and Enuresis.  The panel’s main charge is to assess the fairness of the PEB’s determination that adjustment disorder with depressed mood and enuresis conditions, Category IV conditions, were not unfitting.  The adjustment disorder with depressed mood and enuresis conditions were not profiled, implicated in the commander’s statement, found on a LIMDU or were not judged to fail retention standards.  The enuresis was noted on a document dated 8 January 2008 as existing prior to service (EPTS).  The CI “admitted being injured in a dirt bike accident approximately 2 years prior to entering boot camp” and that he had been given a waiver.  There was not a waiver found in the CI’s file.  On a psychiatric examination document dated 30 January 2008, the CI reported “symptoms of depression secondary to problems at home as well as recently being told that he has a stress fracture in his hip.”  The CI also admitted he had problems with enuresis prior to coming to boot camp when he was “stressed” or had a lot of problems to deal with at one time.”  There was no performance-based evidence from the record that 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 contended conditions and so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the left femoral neck stress fracture condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  In the matter of the contended adjustment disorder with depressed mood and enuresis conditions, the Board unanimously recommends no change from the PEB determinations as not unfitting.  There are 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 20150615, w/atchs
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 10 May 17

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and 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 USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXX, former USN

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