RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02236
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20071024

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E5, Human Resources Specialist, medically separated for “chronic 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 Board’s scope of review is defined in DoDI 6040.44.  It is limited 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.  Any conditions outside the Board’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 Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’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 Board 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 Board 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 - 20070720	VARD – 20150814	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Chronic Right Hip Pain…	5099-5003	10%	Right Hip Athralgia	5251	10%	20150723	
			Limitation of Flexion, Right Hip	5252	0%		
			Impairment of Right Hip	5253	0%		
COMBINED RATING:  10%	COMBINED RATING OF ALL VA CONDITIONS:  40%	

ANALYSIS SUMMARY:  

Chronic Right Hip Pain.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s chronic right hip pain condition began in April 2004 after running.  The CI underwent surgery that included an anterior arthrotomy with the patient's right hip joint and osteoplasty of the right femoral head and acetabuloplasty of the labrum and acetabular rim.  Despite treatment, the right hip condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and the CI was referred for MEB.  The MEB forwarded “right hip pain in the waist” for PEB adjudication.  At the MEB examinations (recorded on DD Forms 2807 and 2808) dated April 2007 and May 2007, 6 and 5 months prior to separation respectively, the CI reported using a cane when needed for ambulation, taking Flexeril and had persistent pain and muscle spasms.  Physical examination elicited pain with internal rotation at the hip and demonstrated limitation of range of motion (ROM) due to the pain.  The MEB NARSUM examination on 8 June 2007, 4 months prior to separation, noted complaints of persistent right hip pain.  The CI stated that he used a cane for ambulation when the pain was severe.  The pain was exacerbated with walking, running, jumping, sitting and arching.  The pain was relieved with resting or lying down.  The CI admitted to waking at night due to the pain.  The CI used Motrin to help alleviate the pain.  Physical examination showed goniometric ROM, average of three repetitions, at the right hip was flexion 135 degrees (normal 125), extension normal, internal rotation 25 degrees, external rotation 30 degrees (normal 45).  ROM was limited by pain.  The examiner noted constant severe right lateral hip pain characterized as sharp pain deep in the joints.  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the chronic right hip pain condition 10%, coded analogously as 5099-5003 (degenerative arthritis), citing the US Army Physical Disability Agency (USAPDA) pain policy.  The VA Compensation and Pension examination was not probative for it was performed approximately 8 years after separation.  The examinations proximate to separation did not demonstrate the presence of hip ankylosis.  There was no fracture, non-union, or malunion of the femur to support consideration under the respective codes for hip impairment related to long bone conditions (5255).  There was no thigh limitation of flexion to 45 degrees or loss of abduction beyond 10 degrees (5252, 5253). There is therefore no VASRD §4.71a route to a rating higher than the 10% adjudicated by the PEB under any applicable code.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board 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 Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150817, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170004219, 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