RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01755
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20091110

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E2, Trainee, medically separated for “tenosynovitis referred to as right hip pain,” with a disability rating of 10%.

CI CONTENTION:  The CI requested a review of all conditions.  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 - 20091029	VARD – NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Tenosynovitis Referred to as Right Hip Pain ...	5024	10%	No VA Examination in Evidence	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Tenosynovitis Referred to as Right Hip Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI suffered an onset of right hip pain with running in late May 2009 (2 months after enlistment, 6 months before separation).  A bone scan (X-ray and MRI were normal) demonstrated stress changes consistent with the working diagnosis of illiotibial band syndrome (fascial and tendon inflammation).  There was no outpatient STR clinical evidence probative to range of motion (ROM) or other rating criteria.  Surgery was not indicated; conservative treatment did not result in sufficient improvement to allow unrestricted duty; and the CI was referred for MEB.  

The 18 August 2009 NARSUM examination, 3 months before separation, documented “frequent ...not daily” pain rated 8/10 “aggravated by walking greater than a mile” and prohibiting running.  The physical examination recorded “a mild limp” and tenderness over the illiotibial band.  Measured ROM was average flexion to 105 degrees (normal 125, 45 for minimum 10%), average extension to 35 degrees (normal 20), and average abduction to 35 degrees (normal 45, 10 for minimum 10%); specifying painful motion.  There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip pain condition 10%, coded 5024 (tenosynovitis) citing painful motion.  There was no ROM limitation, ankylosis, flail joint or instability that would justify a rating higher than 10% under any other applicable code available in VASRD §4.71a; other than consideration of analogous rating under code 5255 (femur, impairment of) which offers higher ratings for contiguous hip disability.  Members agreed, however, that the analogous application of this fracture code was not sufficiently justified by VASRD §4.20 (analogous ratings) in this case which satisfies compensable criteria under more applicable joint codes.  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 of the right hip condition.

BOARD FINDINGS:  In the matter of the right hip condition and IAW VASRD §4.71a, the panel unanimously recommends no change in the PEB adjudication.  There are 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 20150629, w/atchs
Exhibit B.  Service Treatment Record

AR20170008795, XXXXXXXXXXXXXXXXXX.

XXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX:

	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