RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02035
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20030409

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E3, Basic Trainee, medically separated for “left femoral neck stress fracture” 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 - 20030303	VARD - 20030624	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Femoral Neck Stress Fracture…	5099-5003	0%	Degenerative Arthritis, Left Hip, S/P Screw Fixation	5010	0%	20030611	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Left Femoral Neck Stress Fracture.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left hip condition began in July 2002 following a 3-mile run.  Initial X-rays were normal, but a follow up X-ray showed a possible early stress fracture.  This was confirmed on bone scan on 12 August 2002.  The CI was admitted to bedrest with improvement in his symptoms.  He elected to undergo surgical correction to prevent progression of the fracture.  This was accomplished on 14 August 2002, and had no post-operative complications.  He was discharged on 26 August 2002 to convalescent leave.  After a total of 12 weeks convalescent leave, he was placed into the Physical Therapy Rehabilitation Platoon (PTRP).  However, he was not able to return to full activity without pain. 

At the MEB NARSUM examination dated 28 January 2003, 3 months prior to separation and 5 months after surgery, the CI reported recurrent pain after running 1 mile.  On examination, tenderness was absent and flexion symmetric.  Internal and external rotation were 10 degrees less on the left than the right.  X-rays showed healing of the stress fracture.  

At the VA Compensation and Pension (C&P) evaluation performed on 11 June 2003, 2 months after separation and 10 months after surgery, the CI reported no pain with standing or walking up to 1 mile.  He did endorse hip pain after moving furniture up three flights of stairs when he moved into a new apartment, but reported resolution by the next day.  On examination, his gait was normal.  Flexion was reduced to 110 degrees (normal 125), external rotation to 30 degrees (normal 60) and adduction to 30 degrees (normal 45).  The motion of the left hip was symmetric to the right though and pain free implying that this is normal for this individual.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the hip condition 0%, analogously coded 5003 (arthritis, degenerative), citing degenerative arthritis without loss of joint motion.  The VA also rated the left hip condition 0% coded 5010 (arthritis, due to trauma), based on the C&P examination 2 months after separation, citing a non-compensable rating because there was no objective evidence of painful or limited motion of the left hip.  The panel noted that the limitation in motion was symmetric bilaterally.  However, even comparing it the VA normal values, it was not compensable.  There was not documented swelling, muscle spasm, or objective evidence of painful motion to support a 10% rating using the 5003 code.  The panel found no route to a compensable rating.  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 left hip condition.  

BOARD FINDINGS:  In the matter of the left 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. 

AR20170014664, 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.