RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02080
BRANCH OF SERVICE:  MARINE CORPS 	SEPARATION DATE:  20030711

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Marine Corps Reserve E3, Field Radar Operator, medically separated for “persistent left thigh pain, status post (S/P) intramedullary fixation for a closed left femur fracture” with a disability rating of 10%.  

CI CONTENTION:  The CI’s condition continues to worsen.  The 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 - 20061004	No VA Examination in Evidence	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Persistent Left Thigh Pain, S/P Intramedullary Fixation for a Closed Left Femur Fracture	5299-5003	10%		
RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Persistent Left Thigh Pain, S/P Intramedullary Fixation for a Closed Left Femur Fracture.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s sustained a left femur (thigh bone) fracture on 7 February 2004 when ejected from a car during a motor vehicle accident (MVA).  He was taken to surgery that same day and the femur repaired with an intramedullary rod (a large nail inside the bone).  Following surgery, he underwent rehabilitation (it does not appear that he had formal physical therapy) and gradually returned to full weight bearing with persistent pain on prolonged walking and running.  

The MEB NARSUM examination was dated 23 May 2006, over 2 years after the surgery.  It is not clear from the record when the CI was released from the Marine Corp Reserve.  It recorded that the CI worked as a crane operator in a steel plant.  On examination, the incisions were well healed, but mild tenderness to palpation was present.  The range of motion (ROM) was full other than adduction which was limited to 25 degrees (normal 45), but it was symmetric with the non-injured right side.  The knee was non-tender, stable, and had full ROM.  A moderate amount of quadriceps atrophy was present.  Motor function was recorded as 5/5, but somewhat less than the right side.  X-rays showed that the fracture was well healed.  The gait was not recorded.  Physical therapy for the persistent pain was recommended.  Consideration of removal of the surgical hardware was recommended if the pain persisted despite physical therapy.  

There was not a VA Compensation and Pension (C&P) evaluation in evidence.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the persistent left thigh pain condition 10%, coded 5299-5003, analogous to degenerative arthritis.  There was no a VA rating in evidence.  The panel considered the evidence.  The CI was considered to be clinically and radiographically healed with persistent pain.  The ROM was full other than adduction which was symmetric to the right.  The limitation was not compensable under a specific code for the hip (5253, impairment of the thigh).  The strength was full although less than the uninjured side.  The panel found no route to a rating higher than the 10% adjudicated by the PEB under 5003 which supported a 10% rating for painful, limited motion with X-ray pathology.  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 persistent left thigh pain condition.  

BOARD FINDINGS:  In the matter of the persistent left thigh pain, status post intramedullary fixation for a closed left femur fracture which is now healed 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 20150727, with attachments
Exhibit B.  Service Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44

      In accordance with reference (a), I have reviewed the cases listed below and approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
	 	- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC
		- XXXXXXXXXXXXXXXXXX, former USMC

		
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