RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02049
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20050622

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, motor Transportation Operator, medically separated for “chronic pain left thigh” with a disability rating of 10%.

CI CONTENTION:  The CI contended he should also receive ratings for VA service connected 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 panel 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 - 20050401	VARD - 20150812	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Pain Left Thigh	5099-5003	10%	Left Femoral Stress Fracture	5255	0%	STR	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:

Left Thigh.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s left thigh condition began in June 2003 after motor vehicle accident.  Surgery and physical therapy treatment did not result in improvement sufficient to allow unrestricted duty.  The 21 January 2005 MEB NARSUM examination, 5 months prior to separation, noted complaints of moderate and constant pain that required narcotics for pain relief.  Physical examination showed tenderness to palpation over the mid and proximal thigh.  There were no skin defects.  His incisions over were healed.  The range of motion of his hip measured with a goniometer was as follows: Hip flexion was 100 degrees (125 normal), no hip flexion contractures; abduction 45 degrees (0-45 normal) and 10 degrees (45 normal) of adduction, which is symmetric to his opposite side.  The range of motion of his knee showed that he had 5 degrees of extension and flexion of 135 degrees.  Distally he is neurovascularly intact.  He had a mild to moderate antalgic gait with shortened stance time on the left lower extremity.  The 24 August 2015 VA Compensation and Pension (C&P) evaluation, performed over 10 years after separation, was too remote and offers little to no probative value.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic pain left thigh condition 10%, analogously coded 5099-5003 (degenerative arthritis), citing the US Army Physical Disability Agency pain policy.  The VA rated the left femoral stress fracture condition 0% coded 5255 (Femur, impairment of), based on the C&P examination 10 years after separation.  There was no limitation of flexion or extension that supported a rating under the VASRD diagnostic codes for limitation of motion (5251 or 5252).  There was no limitation of abduction or adduction or rotation that supported a rating under the VASRD diagnostic codes for limitation of motion (5253).  There was no hip flail joint that supported a rating under the VASRD diagnostic code (5254).  However, there was evidence of painful motion of the left hip with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  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 chronic pain left thigh condition.  

BOARD FINDINGS:  In the matter of the chronic pain left thigh 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 20150722, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170010032,. 
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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.

A copy of this decision has been provided to the counsel you listed on your application, XXXXXXXXXXXXXXXXXXXXXXXXXXXX.

Sincerely,					      
						      					
Enclosure