RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02175
BRANCH OF SERVICE:  Air Force 	SEPARATION DATE:  20050829

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

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 - 20050715	VARD - 20080715	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain	5318	10%	Right Hip Pain	5252	NSC	20080627	
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Chronic Right Hip Pain.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s right hip pain condition began in 2003 during basic training with no specific injury.  After multiple tests including a CT scan, Magnetic Resonance Imaging, plain film X-rays and bone scan as well as multiple specialty evaluations with orthopedics, rheumatology and neurology no etiology was found.  There was no surgical indication.  The CI was treated with anti-inflammatory medications, narcotics and physical therapy; however, the CI’s right hip pain condition did not improve.  

The 14 June 2005 MEB NARSUM examination, 2 months prior to separation, noted complaints of constant right hip pain that was worse with running and not relieved by rest.  The right hip pain was described as going through the hip from the front to the back and near the time of the MEB NARSUM the CI complained of pain that was in her right buttock.  Physical examination showed a normal gait and normal range of motion.  The CI’s first VA Compensation and Pension (C&P) examination took place nearly 3 years after separation, too distant to provide probative information at the time of separation.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right hip pain condition 10%, coded 5318 (group XVIII, function: outward rotation of thigh and stabilization of hip joint.  Pelvic girdle group 3: (1) pyriformis; (2) gemellus (superior or inferior); (3) obturator (external or internal); (4) quadratus femoris).  The VA did not service connect the right hip condition, coded 5252 (limitation of flexion of thigh), based on the C&P examination 36 months after separation, citing no objective evidence of a disability.  

The panel did not find evidence of loss of use of an extremity to provide a rating using VASRD §4.73 (Schedule of Ratings – Muscle Injuries).  There was no loss of motion of the hip significant enough to justify rating using codes 5250, 5251, 5252 or 5253.  There was no evidence of hip, flail joint to rate using code 5254 or fracture with nonunion or malunion to rate using code 5255.  There was no evidence of painful motion to justify rating using VASRD §4.59, Painful Motion.  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 right hip pain condition.  

BOARD FINDINGS:  In the matter of the chronic right hip pain 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 20150808, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2015-02175.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

XXXXXXXXXXXXXXXXXXX
Director
Air Force Review Boards Agency

Attachment:
Record of Proceedings