RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01475
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20050930

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Security Forces Helper, medically separated for “left femoral neck stress fracture,” with a disability rating of 10%.   

CI CONTENTION:  The CI contends her rating was unjust, that her condition does not prevent her from keeping up with day to day duties, and that she should have never been discharged. The CI’s 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 - 20050815	VARD - 20060912	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Femoral Neck Stress Fx	5252-5299	10%	Left Femoral Neck Stress Fx	5299-5251	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Left Femoral Neck Stress Fracture.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI noted left hip pain on/about 9 February 2005, just over 3 months after accession.  She was seen in sick call several times and treated with medications.  On 18 February 2005, she fell after her hip gave way and the presented to the emergency room the next day.  There she was found to have a non-displaced fracture of the femoral neck (part of the hip) which was treated by a surgical pin on 20 February 2005.  She did well after surgery and was placed on 30 days of convalescent leave at the 2 week post-operative visit.  She was then re-evaluated in orthopedics on 30 March 2005 and found to be doing well.  The range of motion (ROM) was well tolerated and she walked with a minimal limp.  X-rays showed good alignment and healing.  Running was proscribed for another 6 weeks.  Separation was recommended to allow healing with re-enlistment and continued training possible after another 4-6 months of healing.  The 17 May 2005 MEB NARSUM examination, 4 months prior to separation, noted that the CI had continued to improve (since surgery).  She had full ROM without pain and was able to bear her full weight while walking without appreciable limp.  Motor function was normal.  There was no VA Compensation and Pension (C&P) evaluation proximate to separation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left femoral neck stress fracture 10%, coded 5252-5299 (analogous to limitation of flexion of the thigh).  The VA rated the left femoral neck stress fracture 0%, coded 5299-5251 (analogous to limitation of extension of the thigh).  The non-compensable rating was assigned due to the failure to report for the VA examination.  The panel considered these codes and other available for the hip condition and found no route to a rating higher than the 10% rating adjudicated by the PEB.  The panel noted that the full and pain free motion supported a 0% rating; however, the panel cannot recommend a lower 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.  

BOARD FINDINGS:  In the matter of the left femoral neck stress fracture 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 20150609, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-01475.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings