RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01501
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20070630

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Human Resource Specialist, medically separated for “right hip pain” with a disability rating of 0%.  

CI CONTENTION:  The CI contends that her condition limits her ability to do basic functions, i.e. play with her children.  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 - 20070413	VARD - 20090401	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Pain, Right Hip	5099-5003	0%	Status Post Stress Fracture, Right Femoral Neck	5255	0%	STR	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Pain, Right Hip.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right hip pain condition began in June 2006, during basic training with no known specific injury.  The hip pain was initially diagnosed as a non-displaced stress fracture and conservative measures were instituted.  After two weeks her condition had not improved sufficiently and percutaneous screw placement was accomplished. In November 2006 a radiographic study showed no residual fracture.  Following an adequate time of therapy, the hip pain could not be adequately rehabilitated to allow for unrestricted activity and for the CI to fulfill the physical requirements of her military specialty.  The MEB forwarded “continued right hip pain from femoral neck stress fracture after previous percutaneous screw placement” for PEB adjudication.  The 14 February 2007 MEB NARSUM examination on, 5 months prior to separation, noted complaints of deep right hip pain that increased with lower extremity physical activity.  The physical examination showed full range of motion (ROM) of the right hip with painful motion noted.  An addendum to the MEB NARSUM that specifically addressed hip ROM found the right hip to have forward flexion of 130 degrees (normal 125) and extension of 25 degrees (normal 20), adduction 40 degrees (normal 45) and external rotation 50 degrees (normal 45).  The examiner noted painful motion with internal rotation.  There was not a 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 right hip pain condition 0%, analogously coded 5099-5003 (arthritis, degenerative), citing full range of motion.  The VA rated the right hip pain condition 0% coded 5255 (femur, impairment of), based on the STR, citing the CI did not attend either of the scheduled C&P evaluations.  The findings supplied from the X-rays completed 17 November 2006 did not show evidence of arthritis to support a rating using code 5003 (arthritis, degenerative).  The panel agreed that there was insufficient limitation of range of motion to provide a minimum rating using VASRD codes 5251 (thigh, limitation of extension of), 5252 (thigh, limitation of flexion of) or 5253 (thigh, impairment of).  In addition, there was no indication of a flail joint of the hip to support an 80% rating using code 5254, ankylosing of the hip to support a 60% rating using code 5250 or malunion of a femur fracture to support a 10% or higher rating using code 5255.  The panel did find that there was sufficient evidence of painful motion (VASRD §4.59) to support a minimum 10% rating analogously coded 5099-5003 due to the pain with motion.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the right hip pain condition, analogously coded 5099-5003.  

BOARD FINDINGS:  In the matter of the right hip pain condition, the panel unanimously recommends a disability rating of 10%, analogously coded 5099-5003 IAW VASRD §4.71a.  There were no other conditions within the Board’s scope of review for consideration.  

The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
PEB Diagnosis	5099-5003	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150601, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170006469, XXXXXXXXXXXXXXXXXX

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Dear XXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs.

Sincerely,	 
Enclosure