RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01711
BRANCH OF SERVICE:  ARMY 	SEPARATION DATE:  20060719

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Army National Guard Reservist, E4, Imagery Analysis Journeyman, medically separated for “right hip and groin pain,” with a disability rating of 0%.  

CI CONTENTION:  The CI made no specific contention.  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 - 20060419	VARD - 20070309	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Hip and Groin Pain	5099-5003	0%	Residuals; Right Hip Fracture	5255	10%	20060616	
COMBINED RATING: 0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Right Hip and Groin Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right hip condition began in February 2005 after falling while running, resulting in a fracture of her right femoral neck (hip).  On 6 February 2005, the CI underwent surgical fixation of her hip fracture.  The 3 January 2006 MEB NARSUM examination, 7 months prior to separation, noted complaints of an inability to perform any type of jumping activities, prolonged standing, sit-ups, or carry more than 25 pounds greater than 100 yards due to persistent right hip pain.  Her physical examination (PE) revealed a right hip range of motion (ROM) described as “good” in regards to flexion and extension and pain was present with external rotation.  Her gait was without limp.  X-rays revealed surgical screws in place with good evidence of healing across the femoral neck with no collapse noted on the femoral head.

At the 23 March 2007 VA Compensation and Pension (C&P) evaluation, 8 months after separation, the CI reported constant right hip pain characteristically described as squeezing, burning, aching, sharp, and sticking and brought on by physical activity and stress.  She states her condition does not cause incapacitation.  Her reported functional impairment was the inability to run, ski, or bike ride.  Her PE revealed tenderness about the right hip.  There was near normal ROM with pain.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip condition at 0%, analogously coded as 5099-5003 (degenerative arthritis), citing surgical correction.  The VA rated the fractured hip condition at 10%, coded 5255, (femur impairment), based on the C&P examination 8 months after separation.  Panel members first agreed that the inclusion of right groin pain was not a separate condition in and of itself, but rather a referred symptom with regards to the primary unfitting right hip fracture.  Although there was insufficient limitation of motion to support a minimum rating, the panel further agreed a 10% rating was justified for the presence of painful motion as evidenced in the NARSUM examination.  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 condition, coded 5255. 

BOARD FINDINGS:  In the matter of the right hip fracture condition, the panel unanimously recommends a disability rating of 10%, coded 5255 IAW VASRD §4.71a.  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	
Residuals; Right Hip Fracture	5255	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160705, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record 

AR20170008849, 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