RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01706
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20091125

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E1, Basic Trainee, medically separated for “stress fracture, right inferior pubic rami causing hip pain,” 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 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.  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 determinations 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 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 - 20091117	VA - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Stress Fracture, Right...Pubic Rami…	5299-5255	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

Stress Fracture, Right Inferior Pubic Rami causing Hip Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s ride-sided pelvic pain began in March 2009 after her second week of basic training.  Radiographic imaging in May 2009 demonstrated a right inferior public ramus (the lowest part of the pelvis) stress fracture, while later studies in September 2009 showed a healing stress fracture at that location.  The physical therapy examination on 21 September 2009, 2 months before separation, recorded ROM with flexion to 110 degrees (normal 125), extension to 15 degrees (normal 20), and abduction to 40 degrees (normal 45), with painful motion noted.  The orthopedic examination on 25 September 2009, 2 months prior to separation, noted complaints of chronic right sided pelvic and thigh pain, worsened by running, sitting, and walking.  Examination showed tenderness over the right pelvic bone but normal appearance of the pelvis.  The 25 September 2009 MEB NARSUM examination, 2 months before separation, noted complaints of constant pain in the right pelvic area, rated 2/10 in severity, with increases to 7/10 due to running, prolonged standing, walking, and at night.  The CI occasionally took an over the counter medication for pain.  Physical examination showed a normal gait with no scars or abnormalities of either hip, but tenderness was noted along the right pelvis.  Testing for pathology of the hip (FABER test) was positive and neurologic examination was normal.  There was no VA Compensation and Pension evaluation in evidence.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right inferior public rami condition 10%, coded 5299-5255 (analogous to impairment of the femur), citing preserved range of motion and preserved ability to walk without a limp.  The VA did not rate the condition.  The panel considered whether there was a pathway to a higher rating.  There was no evidence of limitation of motion (5251, 5252, 5253) or ankylosis of the hip (5250), though there was evidence of painful motion (VASRD §4.59).  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 inferior public ramus stress fracture.  

BOARD FINDINGS:  In the matter of the right inferior public ramus 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 re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150623, w/atchs
Exhibit B.  Service Treatment Record

AR20170008843, XXXXXXXXXXXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXXXX:

	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