RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01597
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20061025

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E5, Plumber, medically separated for “left hip degenerative arthritis” with a disability rating of 0%.  

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 – 20060817	VARD – 20100925	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Hip Degenerative Arthritis	5003	0%	Left Hip Impingement…	5252	10%	20100820	
Asthma	Not Unfitting	No VA Placement	
Chronic Anemia	Not Unfitting	No VA Placement	
Pes Planus	Not Unfitting	No VA Placement	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Left Hip.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left hip pain began in March 2005 after carrying and lifting heavy equipment while deployed to Iraq.  Diagnostic imaging (MRI) revealed a cartilage tear (longitudinal tear in the anterior superior labrum).  Surgery (arthroscopy and debridement) was performed in August 2005, with the additional diagnosis of femoral head arthritis.  A second surgery (hip dislocation, acetabular osteoplasty, femoral osteotomy) was performed for symptoms of impingement in November 2005.  

At the 5 April 2005 MEB examination (documented on DD Forms 2807 and 2808), 6 months prior to separation, the CI reported tingling of the anterior thigh, and pain that occasionally interfered with sleeping.  The physical examination showed full range of motion (ROM) with pain.  The 16 April 2006 MEB NARSUM examination showed nearly normal ROMs as follows:  flexion to 110 degrees (normal 125), normal extension, abduction to 35 degrees (normal 45), adduction (crossing the legs) to 20 degrees (normal 45), and external rotation (out-toeing) to 30 degrees (normal 45).  The physical therapy examination on 14 June 2006, 4 months prior to separation, noted complaints of continued pain that was worse with maneuvering stairs or lifting.  The physical examination showed lateral tenderness, normal strength, squatting to approximately 60%, with flexion to 90 degrees and external rotation to 40 degrees limited by pain.  An orthopedics examination on 12 September 2006, 1 month prior to separation, noted persistent pain.  The physical examination showed nearly normal ROMs as follows:  flexion to 95 degrees, adduction to 30 degrees, with normal extension, abduction, and external rotation.  Painful motion was noted throughout.  There was no VA examination in evidence proximate to separation.

The panel directed attention to the rating recommendation based on the above evidence.  The PEB rated the left hip condition 0%, coded 5003 (degenerative arthritis).  There was documentation of painful and limited motion and degenerative arthritis in support of a 10% rating under 5252-5003 with application of VASRD §4.59 (painful motion), §4.40 (functional loss), §4.45 (the joints).  There was no evidence of ankylosis (5250), or flexion limited to 30 degrees (5252); no evidence of limitations in abduction (motion lost beyond 10 degrees) in support of a higher rating.  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 left hip condition, analogously coded 5252-5003.  

Contended PEB Conditions:  Asthma, Chronic Anemia, and Pes Planus.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended conditions were not unfitting.  None of the conditions were profiled or implicated in the commander’s statement or judged to fail retention standards.  There was no performance-based evidence from the record that any of 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 any of the contended conditions and so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the left hip condition, the panel unanimously recommends a disability rating of 10%, coded 5252-5003 IAW VASRD §4.71a.  In the matter of the contended asthma, chronic anemia, and pes planus conditions, the panel unanimously recommends no change from the PEB determinations as not unfitting.  There were no other conditions within the panel’s scope of review for consideration.  The panel 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	
Left Hip Degenerative Arthritis Status Post Surgery	5252-5003	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150624, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record  

AR20170008557, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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