RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2015-02248
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051212

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was a Reserve E5, Military Policeman, medically separated for an “injury to left hip…” rated 0%, and “right hip pain…” which was determined to have existed prior to service (EPTS) and was not rated.  The combined disability rating was 0%.

CI CONTENTION:  Review of all conditions requested.  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 - 20050401	VARD - NA	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Injury to Left Hip …	5003	0%	No VA Exam in Evidence	
Right Hip Pain…	5003	EPTS		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NA	

ANALYSIS SUMMARY:  

Left Hip Injury.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), in February 2003 the CI fell from a top bunk and injured his left hip while doing maintenance in the barracks.  The records are scant, but an orthopedic note dated 17 December 2004 recorded that the CI underwent bilateral hip surgery some years before (apparently in 2000 while in high school) and then had a revision (July 2003), following the fall.  On 25 April 2005, the hardware from the revision was removed with expectation of a future total hip replacement.  He was noted to progress well following the surgery and requested a return to full activity at his follow-up appointment on 22 June 2005.  He was noted to have left hip movement without irritability and full (or at least adequate) range of motion (ROM) was implied.  

At the 13 July 2005 MEB examination (recorded on DD Forms 2807-1 and 2808), 5 months prior to separation, the CI reported multiple previous surgical interventions.  The ROM was noted to be decreased, left greater than right, and the gait wide-based (abnormal).  The second MEB NARSUM examination on 12 September 2005, 3 months prior to separation, noted complaints of persistent (left) hip pain which restricted his activities beyond minimal daily walking.  On examination, the ROM of both hips was reduced, but painful motion was not recorded and neither hip was tender.  The strength was normal and, other than a shortened stride, so was the gait.  X-rays showed early bilateral degenerative joint disease with retained hardware in the right hip.  It was anticipated that he would need a total hip replacement at some point in the future.  Flexion was 81 degrees, extension 10, external rotation 21, and abduction 40.  No comment was made on whether the CI could toe-out or could cross his legs.  There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left hip condition 0%, coded 5003 (degenerative arthritis), citing arthritis one major joint.  There was no evidence of painful motion with functional loss supporting a 10% rating (based on §4.59, §4.40 and §4.45).  There likewise was no limitation of motion to attain a 10% rating under the diagnostic codes for degenerative arthritis (5003).  The panel found no route to a higher rating.  Therefore the panel concluded there was not sufficient evidence to support a rating higher than the 0% adjudicated by the PEB.  

Right Hip Pain.  According to the STR and MEB NARSUM, the CI injured his right hip in high school and required surgery.  The initial 4 February 2005 MEB NARSUM noted that his right hip was fine and his duty limitations were from the left hip.  The second 12 September 2005 MEB NARSUM examination noted limited motion of the right hip, but a well-healed scar.  The hip was not tender.  X-rays showed retained hardware and early arthritis.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB determined that the right hip pain status-post surgery was an EPTS condition which was not service aggravated.  A review of the records failed to show that the CI sought treatment for the right hip while on active duty or in the period following separation (although he had a total hip replacement of the left hip).  The PEB adjudication that the right hip condition was EPTS without permanent service aggravation is supported by the evidence.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the right 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.  In the matter of the right 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.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150820, w/atchs
Exhibit B.  Service Treatment Record

AR20170014052, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	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